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Contact Congress to Support The Prohibition Of Self-Referrals For Anatomic Pathology Services

Wednesday, August 13, 2014

ASCP strongly encourages each of you to contact your members of Congress immediately and urge them to co-sponsor H.R. 2914, the “Promoting Integrity in Medicare Act (PIMA).” Introduced on Aug. 1, 2013 by Congresswoman Jackie Speier (D-Calif.), PIMA aims to prohibit the harmful self-referral of anatomic pathology (AP), diagnostic imaging, radiation therapy, and physical therapy services by eliminating these service types from the in-office ancillary service (IOAS) exception to the Stark law.

The IOAS exception was created with the intent to allow providers to self-refer basic, same-day services as a convenience to patients. However, AP services are not physically able to be provided, with results read, during a clinician office visit. Hence, the inappropriate inclusion of AP services under the IOAS exception does not enhance patient convenience, as initially intended by the exception. Rather, it merely perpetuates a financial incentive to over utilize AP services that may not be medically necessary, thereby posing a potential risk of patient harm and costing the healthcare system millions of dollars each year.

Accordingly, the President most recently included in his FY 2015 Budget a proposal to remove AP and other complex ancillary services from the IOAS exception, which the Congressional Budget Office estimated could save approximately $3.4 billion. Securing the passage of PIMA would essentially enact this proposal and recoup the cost-savings associated with the inappropriate inclusion of AP and other complex ancillary services from the IOAS exception while retaining the exception for basic services that truly are able to be performed during the clinician office visit.

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.

To access ASCP's one-page Stark reform issue brief, which cites reputable studies from MedPAC, the Health Affairs Journal, and the Government Accountability Office (GAO) demonstrating the negative byproducts of the inappropriate self-referral of AP services, click here.

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