ACLA Commends Wall Street Journal Story On Self-Referral Loopholes in Medicare Billing for Lab Services

Lab Industry Urges Congressional Action for Stark Law Reform Through Eliminating Anatomic Pathology Services from In-Office Exception 

WASHINGTON, D.C. – The American Clinical Laboratory Association (ACLA), a longstanding advocate of limiting self-referral by physicians, today pointed to a Wall Street Journal story titled “How Medicare ‘Self-Referral’ Thrives on Loophole” (Oct. 22, 2014) as a prime example of the importance of congressional action on Stark law reform.

ACLA has endorsed The Promoting Integrity in Medicare Act of 2013 (PIMA), sponsored by Representative Jackie Speier (D-CA-14), which seeks to remove the existing financial incentives in Medicare for physician self-referral of anatomic pathology services, among others, under the in-office ancillary services (IOAS) exception to the federal self-referral statute.  Specifically, the legislation would exclude anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy from the list of services permitted to be provided by physicians to Medicare beneficiaries under the IOAS exception.  PIMA has also been endorsed by the Alliance for Integrity in Medicare Coalition.

“Rather than cutting reimbursement to all Medicare providers and threatening patient access to important diagnostic services, pragmatic policy dictates removing anatomic pathology services all together from the exception, thereby eliminating the financial incentive to abuse self-referral billing,” said Mertz.

To read the Wall Street Journal story titled, “How Medicare ‘Self-Referral’ Thrives on Loophole,” click here.

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