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.