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Help STOP the Harmful Self-Referral of AP Services in California

Tuesday, April 15, 2014

Help STOP the Harmful Self-Referral of
AP Services in California

California Legislature Considering Legislation to Ban the Self-Referral of Anatomic Pathology Services

Act Now! Legislative Committee Set to Hear Bill on APRIL 21!!!

California State Sen. Ed Hernandez has introduced legislation that would prevent physicians in California from self-referring the anatomic pathology services they order on their patients. The legislation (SB 1215) would change the California state self-referral law’s in-office exception to bar clinicians from billing for self-referred anatomic pathology services as well as advanced imaging services, radiation therapy, and physical therapy.

Current state law prohibits physicians from referring services to entities in which they have a financial interest to ensure that clinical decisions are not influenced by financial gain. The In-Office Ancillary Services Exception was created with the intent to allow providers to self-refer basic, same-day services as a convenience to patients. However, today, the exception is being misused and exploited to allow referring clinicians to bill for the pathologist’s evaluation of biopsied tissues and other complex testing that cannot be performed during the patient's office visit. As a result, the inappropriate inclusion of these complex services is not enhancing patient convenience, but rather driving overutilization, increased costs, and potential patient harm. Accordingly, SB 1215 would close the exception for these complex services, but retain the exception for basic services that are able to be performed with results read during the clinician office visit.

This measure is currently scheduled for a hearing before the Senate Business, Professions, and Economic Development Committee on Monday, April 21, 2014. ASCP, in concert with the California Society of Pathologists, strongly encourages our California members to show their support for SB 1215, preferably before the hearing date.

Click here to access our draft letter on this issue, customize it to your liking, share it with friends, and send it to your legislators.

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