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Protect Illinois Patients: Support Direct Billing Legislation

Monday, April 15, 2013


ASCP needs your help! ASCP, along with the College of American Pathologists (CAP), is asking your Illinois Senators to support pending legislation (SB 1630). The bill provides for direct billing for anatomical pathology services.

The bill will protect Illinois patients against “markup” charges by prohibiting an ordering physician from billing for anatomic pathology services performed or supervised by another physician.

ASCP is concerned about the adverse impact markups have on Illinois’ healthcare system. The potential for profit by marking up test charges can distort medical decision-making, cause over-utilization, increase costs, and result in unfair competition.

Adversely Affect Patient Care

The Federal government mandates direct billing for all federally funded programs to help protect against potential billing abuses. Doesn’t it make sense for states do the same? Any effort to avert questionable billing practices, rein in spiraling healthcare costs, and protect the well-being of patients should be the goal of every state. There are currently 19 states that have laws requiring direct billing for anatomic pathology services, including Arizona, California, Colorado, Connecticut, Iowa, Indiana, Kansas, Louisiana, Massachusetts, Maryland, Montana, New Jersey, Nevada, New York, Ohio, Rhode Island, South Carolina, Washington, and Tennessee.

Additionally, there is an ethical imperative involved. SB 1630 is consistent with ethics standards outlined by the American Medical Association (AMA), which state that “a physician should not charge a markup, commission, or profit on the services rendered by others …”

Clearly the need to preserve the standard of pathology and laboratory medicine and how it is practiced is paramount and has garnered attention in other states. You can help Illinois patients obtain the protections that a dozen or more other states already provide to their patients.

Direct billing assures that patient care and quality come first in the laboratory, and that practices such as mark-ups, over-utilization and inflated healthcare costs are not obstacles in providing quality care.

Your action on this issue should only take a few short minutes and could be the key in assuring direct billing for laboratory services in Illinois.

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