BUDGET WATCH: PROPOSED DEMISE OF THE “IN-OFFICE ANCILLARY SERVICES EXCEPTION” TO STARK
By: Albert R. Meyer, JD, MHA
A key health care component in the President’s FY 2014 budget includes a proposal to eliminate physical therapy services from the “In-Office Ancillary Services Exception to the the federal prohibition self-referrals – the Stark Law.
This exception to the Stark Law, which applies to medical doctors as well as chiropractors, was created to allow physicians to provide certain designated health care services within the confines of their office and not be in violation of the law provided certain conditions are met. In addition to physical therapy the other services being considered for removal include advanced imaging and radiation therapy. Proponents of the measure claim that eliminating these services from the exception will save Medicare more than $6 billion over the next 10 years. It is no surprise that organizations representing physical therapists are strongly lobbying for this provision to come into law.
Physician groups are also speaking out. The American Society of Orthopedic Surgeons (ASOS) warn that “Eliminating the IOAS exception would be detrimental to orthopedic patients because they would no longer be able to receive the continuum of care necessary to recover from musculoskeletal conditions,” argued Dr. John R. Tongue, President of the ASOS. “Fragmentation of care means lower quality and higher costs.”
Since Congress has not passed one of the President’s proposed budgets in years, it is likely that the elimination of the exception will not prevail. However, physicians should keep an eye on the developments and lobbying efforts of the physical therapy lobby and urge their respective professional associations to take action.
We will keep monitoring this issue and will provide more information as further developments emerge.