Why It Matters
Medicare coverage for Image-Guided Superficial Radiation Therapy for skin cancer faces a threat. Medicare Administrative Contractors have proposed eliminating coverage across 38 states, despite over 20,000 lesion outcomes published in peer-reviewed studies. One proposed coverage restriction could reduce Medicare reimbursement by approximately 90%, effectively eliminating IGSRT as a viable treatment option.
This threat emerges as 37 percent of oncologists face payment cuts of 10-20 percent under the 2026 fee schedule and nonmelanoma skin cancer burden among seniors is projected to increase over 140 percent through 2050. DART’s lobbying push targets the bipartisan Radiation Oncology Case Rate Value-Based Program Act while fighting CMS coverage determinations.
By the Numbers
The Dermatology Association of Radiation Therapy Inc. launched federal lobbying in 2025, investing $320,000 total across external and internal efforts.
Externally, DART retained Holland & Knight LLP for $200,000 across five quarterly disclosures focused exclusively on Medicare/Medicaid coverage. This last quarter filing represents a $60,000 payment. Internally, DART conducted lobbying for $120,000 across three reports on medical research and Medicare issues.
The team reflects strategic heavyweight representation. Miranda A. Franco brings healthcare reimbursement experience, including previous work representing SkinCure Oncology LLC on identical IGSRT coverage issues. Jordan K. Brossi served as Health Policy Adviser for Representative Anna Eshoo (D-CA), a senior House Energy and Commerce Committee member with Medicare jurisdiction.
The Agenda
DART lobbies Congress and federal agencies on Medicare and Medicaid coverage for Image-Guided Superficial Radiation Therapy, a nonmelanoma skin cancer treatment. The organization focuses on securing adequate reimbursement and preventing coverage restrictions, particularly countering proposed Local Coverage Determinations that would severely limit IGSRT coverage across multiple states.
DART engages on broader radiation oncology payment reform, including the bipartisan Radiation Oncology Case Rate (ROCR) Value-Based Program Act, which would restructure Medicare radiation therapy reimbursements.
Broader Context
The Radiation Oncology Case Rate (ROCR) Value-Based Program Act, introduced by Senators Thom Tillis (R-NC) and Gary Peters (D-MI), aims to overhaul radiation therapy payments under Medicare. Meanwhile, Medicare Administrative Contractors threaten Local Coverage Determinations restricting IGSRT coverage—a move DART argues ignores 20,000 published patient outcomes.
The 2026 Medicare Physician Fee Schedule imposed additional cuts on radiation therapy services as nonmelanoma skin cancer cases are projected to surge among seniors. DART’s $320,000 lobbying investment positions itself alongside SkinCure Oncology LLC in coordinated industry pressure for favorable coverage policies.
Between The Lines
Congress advances radiation oncology payment reform through the bipartisan ROCR Act, introduced in the Senate by Senators Tillis and Peters and in the House by Representatives Brian Fitzpatrick (R-PA), Jimmy Panetta (D-CA), John Joyce (R-PA), and Paul Tonko (D-NY). The legislation would replace fee-for-service with bundled, site-neutral payments addressing cuts exceeding 20% over the past decade.
Competitive Landscape
SkinCure Oncology LLC actively lobbies on identical IGSRT coverage issues. SkinCure initially hired Holland & Knight with lobbyist Miranda Franco in Q4 2024 before shifting to in-house operations and retaining Wells Health Group LLC. The company’s substantial spending—including a single $130,000 in-house filing for Q3 2025—demonstrates coordinated industry pressure for favorable Medicare coverage determinations.
The Bottom Line
DART’s $320,000 lobbying investment represents broader industry efforts to secure Medicare coverage for IGSRT. The organization employs both in-house and external advocates with Medicare reimbursement expertise, coinciding with congressional discussions on radiation oncology payment reform through the bipartisan ROCR Act.
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