New disclosure requirements to the In-Office Ancillary Services (IOAS) exception, issued as part of the final 2011 Physician Fee Schedule (the “PFS,” a Final Rule with a Comment Period [PDF]), call for physicians to meet minimal, but essential requirements. Section 6003 of the Patient Protection and Affordable Care Act of 2010 (PPACA) amended the IOAS exception to require referring physicians to provide written notice to patients being referred for CT, MRI or PET that the imaging services can be purchased from suppliers other than the physician. Although there was initially confusion regarding the provision’s effective date, CMS clarified in its proposed version of the rule that the additional criteria added by PPACA was not self-implementing and that compliance by physicians would not be required until after the issuance of a final rule.
The Final Rule takes a much more measured approach than the rule as originally proposed. The Final Rule dispenses with the proposed requirement that the required disclosures be signed by the patient and retained by the physician. It also significantly decreases the amount of information physicians are required to provide to patients with regard to alternate suppliers. The net result is a Final Rule that reduces or eliminates many of the more burdensome provisions that had been proposed. Providers should remember, however, that a failure to comply with the Final Rule’s requirements will prevent compliance with the In Office Ancillary Services exception to the Stark law.
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