Right Now

Dec 03 2013

Dr. Coburn Calls for Preservation of In-Office Ancillary Services Exemption in SGR Reform

Pens Letter with Doctor Senators Barrasso, Paul, Boozman

In a letter to the Senate's Majority and Minority Leaders, the Senators express their strong support for preserving the “in-office ancillary services exception” (IOASE) to federal physician self-referral regulations (the “Stark” law). This provision permits physician practices to provide critical services –including radiation therapy, diagnostic imaging, pathology, and physical therapy –in an integrated and coordinated fashion within their respective practices. 

The Senators wrote that they were "concerned that limiting the in-office ancillary services exemption would introduce additional cost and time barriers to patients receiving medically-appropriate screenings and treatments."

"As medical practitioners with decades of combined experience in treating patients," they wrote, " we believe [the Administration's] changes [to the in-office ancillary services exemption] would effectively force more patients to receive these services in hospital settings, thereby increasing costs to patients in private and public programs."  

Moreover, the Senators noted that, "given the number of individuals enrolled in Medicare, Medicaid, and other federal health care programs, a significant portion of these increased costs will also burden taxpayers whose tax dollars fund these public programs." Another serious concern they identified with changes to the IOASE would be that "reducing the use of these services in the outpatient setting could not only drive the services to a higher cost inpatient setting, but could accelerate current trends in provider consolidation and further increase system costs over the long term." 

They also noted the unfair advantage changes would give some provider types. "We believe as an issue of basic fairness, the federal government should not disproportionately favor one care setting over another, especially when such a change will increase costs to taxpayer-backed federal health programs," they wrote. "Repeal of the IOASE would literally make it illegal for physician practices to integrate these ancillary services that would be legally integrated in an inpatient setting."