Expect the decades-old debate about the dangers/benefits of physicians operating their own ancillary services to heat up again this year.
 
A bill introduced in the House of Representatives on Aug. 1 would significantly strengthen restrictions on physician self-referrals.
 
The Promoting Integrity in Medicare Act of 2013, sponsored by Rep. Jacki Speier (D-CA) and co-sponsored by Reps. Jim McDermott (D-WA) and Dina Titus (D-NV), would prevent doctors from owning and referring patients to the following services: advanced imaging (e.g., MRI and CT), physical therapy, anatomic pathology and radiation therapy. Those services would be dropped from the in-office ancillary services exception (IOASE) to the self-referral law.
 
The bill’s sponsors say physicians have gotten out of control with the number of expensive tests and other services they self-refer to those labs, imaging centers or therapy practices. They cite studies by the Government Accountability Office, such as a recent one that found an almost 60% increase in biopsy services when the referring doctor owned the pathology lab.
 
Doctors counter that the services are more convenient for their patients when provided in the physician’s office, and anyway it’s cheaper to pay for the services in a physician’s office instead of an outpatient hospital.
 
The bill mirrors a provision included in President Obama’s fiscal 2014 budget proposal. So limits on ancillary services may become a reality even if the bill fails. For the status of these proposals, and guidance on the potential impact make sure you’re reading Medical Practice Compliance Alert and Medical Practice Coding Pro.