Obama Proposes End to In Office Ancillary Exception
As part of President Obama’s proposed 2014 budget, a provision was included that would close the in-office ancillary services (IOAS) exception to the stark law for radiology, radiation oncology and physical therapy practices. In-office pathology labs were not included in the budget; however, this is merely a proposal and if the Alliance for Integrity in Medicare (AIM) has any input, in office pathology will be included.
In an April 23rd edition of The Pathology Blawg, AIM was quoted as saying, “We believe this loophole results in increased spending, unnecessary utilization of medical services, and potentially compromised patient choice and care, thus eroding the integrity of the Medicare Program.” The coalition went on to say, “AIM strongly urges Congress to follow the lead of the Moment of Truth Project and pass legislation to remove advanced diagnostic imaging, anatomic pathology, and physical therapy from the IOAS exception in the 113th Congress. Reforming this policy will ensure that Medicare patients receive the highest quality and safest health care most appropriate to their needs, and Medicare policy incentives are properly aligned, which is in the best interest of beneficiaries, providers and our nation’s health system overall.”
Time will tell on this issue and others related to the 2014 budget proposal. APS will continue to monitor this proposal and provide an update as soon as information is available. If you have any additional questions, please contact your Practice Manager.
In late summer, 2012, we contracted with APS to do our pathology billing. The company we were previously using lacked experience and know-how in clinical pathology professional component billing. APS has completely fulfilled all of our expectations, both in clinical pathology professional component billing and in all other areas of pathology billing. They performed an audit of our CPT coding and pointed out some areas in which we could improve. Interestingly, a reference lab we were using had erroneously instructed us in how to bill for a certain cytology examination. When APS identified the incorrect CPT coding, the reference lab, after some initial resistance, changed their CPT coding practice for this test. In November 2012, when we renegotiated our contract with the hospital, the CEO of APS flew to Salt Lake City and attended the negotiating meeting. His input during the meeting was extremely valuable in helping us obtain a satisfactory contract. Most significantly, in February, 2013, the hospital where we practice changed the hospital/laboratory information system. The initial interface the computer company offered for transmission of billing information was not satisfactory. APS made heroic efforts in helping the computer company get a satisfactory interface system in place. The APS sales and other personnel with whom I have interacted are highly knowledgeable and very pleasant. If a pathology group is dissatisfied with their current billing arrangement, I highly recommend APS. They have done a fantastic job for us.
Salt Lake City, UT
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