FIND A PROTON CENTER

ADVOCACY ISSUES WITH A SINGULAR GOAL:
Increasing access to this life-saving, life-changing cancer treatment.

Proton therapy, an essential cancer treatment, must be accessible to those who need it most. NAPT members are dedicated to advocating for policies that impact the availability and affordability of proton therapy.

NAPT’s advocacy work focuses on engaging with policymakers to influence decisions that affect proton therapy’s accessibility. By collaborating with lawmakers, insurers, and healthcare providers, NAPT aims to improve coverage and reimbursement policies, reducing financial barriers for patients.

These advocacy efforts have a significant impact, not only on individual patients but also on the broader healthcare system. NAPT’s work contributes to the advancement of cancer care in the United States, ensuring that proton therapy remains a critical and accessible component of comprehensive cancer treatment.

NAPT Resource Center

Explore the NAPT Resource Center for downloadable overviews and data-driven infographics that distill essential information about proton therapy into digestible, visually engaging formats. Whether you’re a patient seeking clarity on a diagnosis or a physician striving to enhance patient care, our resources empower you with the knowledge to make informed healthcare decisions.

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Advocacy Issue:

Patient Access

NAPT is committed to expanding patient access by raising public awareness about the remarkable benefits of proton therapy, securing expanded insurance coverage to ensure affordability, advocating for the strategic expansion of proton therapy facilities in underserved regions, fostering a culture of innovation, and encouraging collaboration among medical professionals and policymakers.

Advocacy Issue:

Prior Authorization

For patients recommended for proton therapy and other advanced cancer treatments, prior authorizations are a burdensome process that often delays life-saving treatment. NAPT has joined patients, physicians, and healthcare facilities to advocate for reforms to the Medicare Advantage Prior Authorization process.

Advocacy Issue:

Payment Stability

A payment model that dramatically changes the delivery of cancer treatment should be carefully designed to encourage innovation while ensuring equitable access to advanced and specialized cancer care.

Innovation in radiation oncology, such as proton therapy, has contributed greatly to better outcomes for cancer patients. It is vital to promote the growth of advanced radiation oncology techniques such as proton therapy by supporting research and the development of well-designed payment models that do not inadvertently hinder future advancements in this field. NAPT is supportive of payment reform that is strategically designed without advancing a single payment rate without appropriately adjusting for the resources, clinical complexity, and other critical considerations.

Payment Stability Resources

RO Model:

Radiation Oncology Alternative Payment Model is an advanced alternative payment model introduced by the Centers for Medicare & Medicaid Services (CMS) in 2019 with the goal to transform the way Medicare pays for radiation therapy services for cancer patients. It replaces traditional fee-for-service payments with episode-based payments with the intended goal of improving the quality of care furnished to Medicare beneficiaries while reducing Medicare spending.  The payment model risked future innovation and the availability of advanced treatments such as proton therapy by reimbursing all treatment modalities at the same rate. CMMI has announced that the RO Model is indefinitely delayed.

CMS Radiation Oncology Model

NAPT Applauds Actions to Prevent Medicare Cuts to Cancer Care

Bi-Partisan House Letter

Senate Letter 2019

Bi-Partisan Florida Delegation Letter

Physician Letter

June 2022 NAPT/PTCOG-NA Comment Letter

Sept 2021 NAPT/PTCOG-NA Comment Letter 

Sept 2019 NAPT/PTCOG-NA Comment Letter

Medicare Physician Payment Scenarios for 2024

ROCR:

The Radiation Oncology Case Rate is an initiative introduced by ASTRO, the American Society for Radiation Oncology, in 2023 to stabilize payment instability in radiation oncology reimbursements.  Payments would be based on a single payment rate for a treatment episode.  This legislative initiative does not include modalities such as proton therapy or brachytherapy.

ASTRO ROCR FAQs

NAPT ROCR Proposed Legislation Summary

ASTRO ROCR Proposed Legislation (full bill)

The Latest Payment Stability News:

Advocacy Issue:

VA Access

The VHA, as America’s largest integrated healthcare system, should provide equitable access to advanced cancer treatments, like proton therapy, to provide the best outcomes for veterans with cancer. Unfortunately, many veterans, depending on the region where they are seeking care, are denied access to proton therapy.  The VHA serves millions of enrolled veterans each year but lags behind Medicare in providing access to advanced cancer treatments like proton therapy. Nearly 50,000 cases of cancer are reported annually in the VA Central Cancer Registry, yet according to the NAPT’s annual survey, less than 250 veterans treated by the VHA received proton therapy in 2022. Equitable access to advanced treatments like proton therapy will support veterans’ well-being and give them the best outcome when faced with a cancer diagnosis.

Advocacy Issue:

State Legislation

In states across the country, NAPT is working with policymakers to remove systemic barriers to cancer care that disproportionately impact communities of color, low-income patients, and those with the most serious and inoperable conditions.