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.