Joint Statement From The Alliance For Integrity In Medicare On The Congressional Budget Office Scoring Of The IOAS Reform Proposal Provision Of The President’s FY 2015 Budget

The Alliance for Integrity in Medicare (AIM), a broad coalition of medical specialty,
laboratory, radiation oncology, and medical imaging groups committed to ending the
practice of inappropriate physician self-referral, is pleased about the release of the
Congressional Budget Office’s score of President Obama’s FY 2015 Budget, released
today.

Specifically, AIM applauds the Congressional Budget Office statement that $3.4
billion in savings to the Medicare program will be generated by excluding anatomic
pathology, advanced diagnostic imaging, physical therapy services, and radiation therapy
from the In-Office Ancillary Services (IOAS) exception to the federal self-referral
statute- an increase of $1.6 billion from the FY 2014 score of $1.8 billion. AIM commends
the Administration not only for including IOAS reform for a second year in its
budget proposal, but also for adding anatomic pathology services to the proposed list of
excluded services in FY 2015. The savings estimate released by CBO for narrowing the
IOAS exception definitively validates that unnecessary expenditures by the Medicare
program would be reduced, if Congress would enact the President’s recommendation.

The ongoing misapplication of the IOAS exception to the aforementioned services
continues to be of grave concern to AIM. Furthermore, the Coalition’s position has
been corroborated by independent evidence, including Government Accountability
Office reports and peer reviewed published research, which consistently demonstrates
that the existing IOAS physician self-referral loophole results in increased spending,
unnecessary utilization of medical services, and potentially compromised patient choice
and care, which erodes the integrity of the Medicare program.

AIM remains steadfastly committed to improving patient care and protecting finite
Medicare resources, therefore we believe the IOAS reform proposal in the President’s
FY 2015 Budget is a laudable step towards those ends. Furthermore, AIM strongly
urges the 113th Congress to build upon the recommendations of the Administration
and to pass legislation that removes advanced diagnostic imaging, anatomic pathology,
radiation therapy, and physical therapy from the IOAS exception, such as H.R. 2914, the
Promoting Integrity in Medicare Act of 2013. Reforming this policy will ensure
that the care Medicare patients receive is the most appropriate to their needs, and not
motivated by potential profit from misaligned incentives —a positive for beneficiaries,
providers and all Americans.

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

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