Healthcare Update: Proposed Bill Would Eliminate Stark Law Exception for Some Services; Oregon Exchange Won’t be Completely Ready by Deadline; “Doc Fix” Bill Advances in House



    The “Promoting Integrity in Medicare Act of 2013,” introduced in the U.S. House of Representatives on August 1, would eliminate one of the Stark Law’s exceptions for advanced imaging, anatomic pathology, radiation therapy and physical therapy services performed in a physician’s office.

    The bill was introduced by Representatives Jackie Speier (D-CA), Jim McDermott (D-WA) and Dina Titus (D-NV). Congresswoman Speier released a summary of the bill. Its sponsors claim that by making the performance of certain medical services illegal, the bill would cut “unnecessary” Medicare expenditures by hundreds of millions of dollars per year.

    The Stark Law prohibits a physician from referring Medicare and Medicaid patients to a facility in which he or she has a financial interest for any of ten categories of “designated health services” unless an exception is available. One of the most-used exceptions, for “in-office ancillary services,” permits the physician to refer his or her own patients for advanced treatment in the same building as his or her primary office. The proposed bill would eliminate this exception for the services listed above. In a press release, McDermott observed, “Over the years, use of the in-office ancillary services exception has dramatically increased, resulting in increased costs to the Medicare program.”

    If the bill or a variation thereof were to become law, it would undoubtedly require countless “in-office” facilities to restructure or completely unwind their arrangements with referring physicians.

    For a complete copy of the Update click here.

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