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On August 1, 2013, Representative Jackie Speier (D-CA-14) introduced the Promoting Integrity in Medicare Act of 2013 (H.R. 2914) that proposes to remove anatomic pathology, along with other services including advanced diagnostic imaging, radiation therapy and physical therapy, from the In-Office Ancillary Services Exception to the Stark law. The legislation does not include any grandfathering or exceptions. Thus, it appears that the legislation, if passed, will put an end to the in-sourcing of anatomic pathology by referring physicians. The legislation also directs the government to scrutinize these services more carefully with prepayment reviews, claims audits, focused medical review, and computer algorithms designed specifically to identify payment or billing anomalies.

As it is unclear which committee has jurisdiction over the legislation, it was referred to both the Committee on Energy and Commerce and Committee on Ways and Means. We will issue a subsequent client alert if the legislation gains any further traction.

For more information, please contact:

Jenny McGovern

Jane Pine Wood

McDonald Hopkins has a large and diverse healthcare practice, which is national in scope. The firm represents a wide variety of healthcare providers, facilities, vendors, technology companies and associations. Our diverse experience enables us to give our clients a unique perspective on the issues that may confront them in the rapidly evolving healthcare environment.