Just after midnight on December 20, a chaotic lame duck Congress finished 2024 without blocking Medicare physician payment cuts or restricting prior authorization, a deeply disappointing finish for physicians and radiation oncology.

Up against a December 20 government funding deadline, the House then Senate passed legislation to continue federal spending until March 14, 2025—effectively a cut for agencies like the National Cancer Institute—and extended telehealth flexibilities until March 31. Earlier this week, a deal collapsed that would have mitigated most of the 2.93% physician payment cuts scheduled for January 1, but also failed to include bipartisan prior authorization reform legislation.

ASTRO and other physician organizations will begin work immediately to influence the new Congress and Administration to retroactively fix the Medicare cuts, pass the Improving Seniors Timely Access to Care (S.4532/H.R. 8702) prior auth bill, and increase cancer research funding for this fiscal year and next. ASTRO already has started the process of reintroducing the Radiation Oncology Case Rate (ROCR) Act in the new Congress. With major changes expected for radiation therapy coding and payments in 2026, there is great urgency to pass ROCR next year.

Thanks to all the ASTRO members that engaged in advocacy in 2024, and we look forward to working with you in 2025 to overcome these serious challenges facing the specialty and radiation oncology patients.