2023 Advocacy Accomplishments

Medicare

• Developed and secured member support for Radiation Oncology Case Rate (ROCR) proposal.
  • Executed rollout through webinars, town hall, modeling tools, FAQs, Annual Meeting sessions, earned media and 1-1 discussions with more than 1,000 members.
  • Engaged radiation oncology stakeholders and policy experts, including Medicare Payment Advisory Commission Chair and staff.
  • Drafted legislative language with congressional champion and engaged numerous congressional offices.
• Partnered to advance legislation addressing Medicare payment cuts, including conversion factor fix, fee schedule reforms and clinical labor cuts mitigation.
• Prevented expected CMS-led revision of radiation therapy G-codes.
• Ensured that any extension of the COVID-19 PHE virtual flexibility for direct supervision of the weekly treatment management OTV would not go beyond 2024 without rulemaking.
• Analyzed, summarized and submitted comments on Medicare payment rules.

Coding and coverage

• Hosted 2023 Coding and Coverage seminar with a record 140 attendees; secured American Society of Radiologic Technologists (ASRT) CE credits.
• Generated more than $232,000 in 2023 Coding Resource revenue; produced 2024 Coding Resource with new codes, radiopharmaceuticals, image guidance, ROCR and more.
• Secured code edits that align billing of Superficial Radiation Therapy (SRT) with ASTRO’s Coding Resource guidance.
• Met with CMS officials, submitted guidance and organized sign-on letter about the use of image guidance with SRT.
• Finalized update to ASTRO’s Proton Beam Model Policy.
• Established biannual meetings with UnitedHealthcare (UHC) leadership; secured “split decision” process approval for initial treatment and addressing missed peer-to-peer calls.
• Met with Cigna and eviCore leadership to address prior authorization issues and coverage determinations.
• Obtained Magellan policy update that allows billing of a special radiation therapy treatment code for concurrent chemo/immunotherapy.
• Secured revisions to Washington State SBRT coverage policy to include hepatocellular carcinomas, pancreatic adenocarcinomas, localized prostate cancers, oligomets and more.
• Engaged Politico on prior authorization article that extensively quoted ASTRO leaders and information; helped secure more than 300 Hill signatures on prior auth reform letter.
• Analyzed, summarized and submitted comments on Medicare Advantage proposed rules and requests for information on contracting, prior authorization, coverage and interoperability.
• Staved off, for at least two years, revaluation of treatment delivery and image guidance codes.
• Urged completion of AMA’s new Physician Practice Information Survey (PPIS) and advocated for supplemental survey to properly capture radiation oncology practice expense costs.
• Developed code change application for new codes related to dosimetric work involved in radiopharmaceutical therapy; plan to submit multi-specialty application to the CPT in 2024.
• Secured appointment of ASTRO’s RUC advisor to RUC Administrative Subcommittee tasked with the maintenance of the RUC’s procedural issues.

Security and safety

• Clarified Massachusetts accreditation regulations involving CT scanners, clearing path for APEx accreditation.
• Developed educational materials on becoming an authorized user following American Board of Radiology’s termination of its AU certification process.
• Blocked Arizona legislation that would have reduced supervision requirements.
• Hosted tours of University of Virginia and the University of Maryland for National Nuclear Security Administration staff in partnership with Source Security Work Group.
• Advocated with Congress and agencies to resolve drug shortages, including Lutetium-177.

Cancer research

• Presented to President’s Cancer Panel on radiation oncology contributions to National Cancer Goals.
• Partnered with cancer research organizations to advocate for funding increases for NIH and NCI in FY24 appropriations bill.
• Participated in multiple cancer research funding focused Hill fly-in days.
• Advocated for distinct ARPA-H funding that avoids reducing existing cancer research funding.
• Supported successful confirmation of NIH Director Dr. Monica Bertagnolli.

PAC and grassroots

• Hosted Advocacy Day in Washington, DC, with 77 members attending 98 congressional meetings; highlighted survey on rising costs facing practices.
• Raised more than $85,000 from more than 303 members for ASTRO PAC.
• Coordinated grassroots alerts producing 405 messages to Congress from 227 advocates.
• Raised $25,000 and hosted clinic tour for key Senate champion.
• Established initial GR Fellowship for residents; received 10 applications for 2024.
• Assisted members in hosting site visits for key members of Congress.
• Filed accurate and timely political and lobbying compliance reports.

Health equity

• Developed ASTRO Climate Change policy statement recognizing the impact of climate change on cancer care and establishing key action areas for future development.
• Established cervical cancer workgroup on undervalued services and identified opportunities to collaborate with other organizations on securing better reimbursement, access.

Member communications

• Adopted “Smart Brevity” writing style to improve written communications to members.
• Educated members, stakeholders, policymakers and the public on policy agenda through ASTRO communication vehicles, presentations, earned media and external meetings.