Proposed HR 2143, would prevent physicians from self-referring Medicare patients to in-office “ancillary services.” According to the Congressmen who introduced the bill:
“Multiple GAO studies have outlined the rampant abuse and waste of more than $3 billion of taxpayer money through Medicare reimbursement for unnecessary services that are driven purely by greed for personal profit,” Speier said in a statement. “Now is the time to improve the quality and cost-effectiveness of Medicare.”
“Seniors should have full confidence that their doctors are making medical decisions based on each patient’s health care needs, not the physician’s financial interests,” Titus said in the same statement. “This legislation will save taxpayer dollars, strengthen Medicare, and help ensure that our seniors receive the care they deserve.”
As reported by Radiology Business last week, the American Society of Radiology Oncology (ASTRO) quickly came out with a press release applauding the introduction of the new bill. In the statement, ASTRO said the Ethics in Patient Referrals Act—enacted in 1989—was designed to prohibit “physicians from referring a patient to a medical facility in which the physician has a financial interest.” But the exceptions for in-office ancillary services have “diluted the self-referral law and created a pathway for physicians to avoid its prohibitions and intent.”
But AMGA—formerly the American Medical Group Association—released its own statement April 16 expressing concern with the proposed bill. The association said the legislation could restrict physicians in multispecialty groups from referring patients for advanced imaging services within their groups, which AMGA believes could actually drive up healthcare costs and impede care coordination and integration.
It also raises the possibility that rural patients could have gaps in care if they can’t receive imaging services within the same practice, according to the statement.