A Statement from the Alliance for Integrity in Medicare (AIM)

WASHINGTON, DC – The Alliance of Integrity in Medicare highlights a new report out by the Congressional Budget Office (CBO) last week that increased the Medicare savings score in the President’s FY 2016 budget for the narrowing In-Office Ancillary Services (IOAS) exception. According to CBO the savings associated with IOAS reform rose $100 million from last year to $3.5 Billion, representing additional Medicare savings that could be used in legislation to permanently fix the Sustainable Growth Rate (SGR).

AIM, a broad coalition of medical specialty, laboratory, medical imaging, and radiation oncology groups committed to ending the practice of inappropriate physician self-referral, has been a leading advocate for the removal of anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy from the physician self-referral law’s IOAS exception. Subtracting just the aforementioned services from the IOAS exception would protect seniors, promote integrity in the practice of medicine, and as noted by the CBO, save the Medicare program billions of dollars.

In letters delivered to key House and Senate committees as well as leadership today, the Coalition stated with regard to the exclusion of specific services from the IOAS exception, “In addition to improving patient care and reducing inappropriate utilization of health care services, enactment of this policy will generate substantial savings to the Medicare program which, in turn, can be used to finance SGR reform.”

AIM asserts there is substantial evidence that the IOAS exception often is exploited by physicians for their own financial self-interest, as found by the Government Accountability Office, the Office of the Health and Human Services Inspector General, and academic, peer-reviewed research. There is no better time to eliminate the perverse financial incentives currently fostered by the IOAS exception.

Removing anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy from the IOAS exception will help remedy several compelling issues at once. So as Congress looks for options to pay for a permanent ‘doc fix,’ AIM strongly urges legislators to consider the Medicare savings incurred by reforming the IOAS loophole.

Members of The Alliance for Integrity in Medicare include American Clinical Laboratory Association, American Physical Therapy Association, American Society for Clinical Pathology, American Society for Radiation Oncology, Association for Quality Imaging, College of American Pathologists and the Radiology Business Management Association.

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