Our Priority: Preserve Appropriate Use of In-Office Ancillary Services
Why the Issue Matters
The in-office ancillary services exception (IOASE) to federal self-referral regulations (the "Stark law"), allows 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 medical profession has taken significant steps to ensure that only medically necessary and appropriate ancillary services are performed. These steps include the development and implementation of training guidance, appropriate use criteria, practice guidelines, and decision support tools that assist physicians in delivering the most appropriate care. The Congress and the U.S. Department of Health and Human Services (HHS) have heavily regulated the provision of such services through the "Stark law" and elsewhere. Physicians and group practices relying on this exception must meet complex billing, supervision, and location requirements.
The AUA works to preserve appropriate use of the IOASE exception and to remove barriers that prevent urologists from participating in value-based payment models.
What the AUA is Doing
H.R. 2282 & S. 966, The Medicare Care Coordination Improvement Act – introduced in the House by Reps. Raul Ruiz, MD (D-CA-36), Larry Bucshon, MD (R-IN-08), Ron Kind (D-WI-03), and Kenny Marchant (R-TX-24) and in the Senate by Sens. Rob Portman (R-OH) and Michael Bennet (D-CO) – would:
- Modernize the physician self-referral prohibitions;
- Promote care coordination in the MIPS program; and
- Facilitate physician practice participation in alternative payment models under the Medicare program