Cost-Based Stark Law Changes Under Consideration By Ellen F. Kessler and Melvyn B. Ruskin

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Major reforms to the Stark Law's "In-Office Ancillary Services" (IOAS) exception1 and the current Medicare payment system may be on the horizon.

On June 15, 2010, the Medicare Payment Advisory Commission (MedPac) issued a 267 page report to Congress (MedPac Report).2 MedPac is an independent congressional agency established by the Balanced Budget Act of 1997 to advise Congress on issues affecting the Medicare program.

Although MedPac is only authorized to study and analyze issues and make recommendations to Congress, its recommendations are typically given serious consideration by Congress and the Centers for Medicare and Medicaid Services (CMS) and are often incorporated into new laws and regulations.

The recent MedPac Report covered numerous issues relating to Medicare, including changes in payment policy, graduate medical education and a reformed healthcare delivery system. The focus of this article, however, is limited to the new strategies MedPac is considering regarding Medicare payments for expensive diagnostic tests, including MRIs, CT scans, PET scans, cardiac imaging stress tests and therapy services, such as radiation therapy and physical therapy.

Please see full article below for more information.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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