FAIRFAX, VA--(Marketwired - March 04, 2014) - 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 extremely pleased that President Obama's FY 2015 Budget, released today, recommends the exclusion of anatomic pathology, advanced diagnostic imaging, therapy services, including physical therapy, and radiation therapy from the In-Office Ancillary Services (IOAS) exception. AIM has long supported additional limitations on physician self-referral, and we applaud the Administration for including IOAS reform for a second year, and also for adding anatomic pathology services to the proposed list of excluded services.
The organizations comprising the AIM coalition continue to be concerned about the ongoing misapplication of the IOAS exception to the physician self-referral law. Independent evidence including from the Government Accountability Office(i), Health Affairs(ii), and the New England Journal of Medicine(iii) consistently shows that the physician self-referral loophole results in increased spending, unnecessary utilization of medical services and potentially compromised patient choice and care, thereby eroding the integrity of the Medicare program.
AIM applauds the Administration's FY 2015 Budget for recommending the exclusion of anatomic pathology, advanced diagnostic imaging, radiation therapy and physical therapy services from the IOAS exception, except in cases where a practice meets "certain accountability standards, as defined by the Secretary of the Department of Health and Human Services." The Office of Management and the Budget estimates that closing the loophole for these services would provide a savings of $6 billion dollars during the standard ten-year budget window.
The AIM coalition remains steadfastly committed to improving patient care and preserving valuable 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. Reforming this policy will ensure that Medicare patients receive the highest quality and safest health care most appropriate to their needs, in addition to properly aligning Medicare policy 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
i. A series of 2013 GAO reports requested by bipartisan leaders in Congress examining the rise of self-referrals found increases in self-referrals for magnetic resonance imaging (MRI), computed tomography (CT) services, and anatomic pathology services ordered by physicians who self-refer, when compared to those physicians who do not.
ii. Mitchell, J.M. (2012). "Urologists' Self-Referral For Pathology Of Biopsy Specimens Linked To Increased Use And Lower Prostate Cancer Detection." Health Affairs, 31:4741-749.
iii. Mitchell, J.M. (2013). "Urologists' Use of Intensity-Modulated Radiation Therapy for Prostate Cancer." The New England Journal of Medicine, 369, 1629-1637.
The Alliance for Integrity in Medicare (AIM) is a broad coalition of medical societies committed to ending the practice of inappropriate physician self-referral and focused on improving patient care and preserving valuable Medicare resources. AIM partners include the American Clinical Laboratory Association (ACLA), the American College of Radiology (ACR), the American Physical Therapy Association (APTA), the American Society for Clinical Pathology (ASCP), the American Society for Radiation Oncology (ASTRO), the Association for Quality Imaging (AQI), the College of American Pathologists (CAP) and the Radiology Business Management Association (RBMA). More information is available at www.aimcoalition.com.
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