Self-referral bill may be folded into health reform

A bill introduced into the U.S. House of Representatives in June that would close the in-office ancillary service exemption for MRI, CT, and PET allowed under the Stark anti-self-referral law may be added to a healthcare reform package currently under consideration in Congress.

Rep. Jackie Speier (D-CA) introduced HR 2962, or the Integrity in Medicare Advanced Diagnostic Imaging Act of 2009, as a standalone bill on June 19. Now, Rep. Anthony Weiner (D-NY) and Rep. Bruce Braley (D-IA), members of the House Energy and Commerce Committee, are planning to offer Speier's bill as an amendment to the healthcare reform package currently being debated in their committee, which is one of three House committees debating the legislation, according to the American College of Radiology (ACR) of Reston, VA.

In a July 20 letter to ACR membership, ACR chair Dr. James Thrall urged radiologists to register their support of the amendment with Congress.

"Please be aware that passage of this amendment will be extremely difficult," Thrall wrote. "There is no issue in medicine that is as divisive as ownership within a physician's office. We can expect the full force of organized medicine to fight [it]."

Even if the self-referral amendment passes, Speaker of the House Nancy Pelosi (D-CA) and House leadership could choose not to hold a floor vote on the bill if too many amendments have been added to it, Thrall said.

"They could instead schedule a floor vote on the healthcare bill from the Ways and Means Committee, whose Health Subcommittee Chairman, Congressman Pete Stark [D-CA], opposes amending the Stark law," Thrall wrote. "If that happens, the ability to offer a self-referral amendment to that bill on the House floor is doubtful."

In an action alert, also on July 20, the ACR encouraged its members to recommend that their congressional representatives contact Reps. Weiner and Braley and offer support for the amendment.

Related Reading

House bill would close Stark in-office loophole, July 2, 2009

MedPAC: Self-referring docs use more imaging, June 23, 2009

Senate report offers details on accreditation, Stark disclosure, May 6, 2009

The Profit Center: Part 2 -- Steering clear of Stark and false-claims violations, March 31, 2009

Tucson cardiologists settle Stark law case, March 20, 2009

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