ACLA Endorses Bill To Reduce Overutilization, Increased Medicare Spending In Anatomic Pathology Services

WASHINGTON, Aug. 2, 2013 /PRNewswire-USNewswire/ -- The American Clinical Laboratory Association (ACLA) applauded the introduction of H.R. 2914, The Promoting Integrity in Medicare Act of 2013, introduced by U.S. Representative Jackie Speier (D-CA14). This important legislation addresses the financial incentives for self-referral of anatomic pathology services, among others, under the in-office ancillary services exception to the Stark Law. ACLA has had longstanding, serious concerns about physician self-referrals in anatomic pathology and has sought to curtail this practice, along with other Alliance for Integrity in Medicare Coalition members.

"ACLA applauds Representative Speier for taking legislative action to remove anatomic pathology, advanced diagnostic imaging, radiation therapy, and physical therapy services from the IOAS exception, as narrowing it is in the best interests of patients, providers, and the Medicare program. This solution is optimal since it attacks the true drivers of utilization, physicians. For far too long CMS has addressed utilization increases through broad, nonspecific cuts to referral laboratories- which have no control over the volume of services ordered by physicians. Passage of this legislation will allow better control of our nation's health care expenditures under Medicare which ultimately benefits us all," said Alan Mertz, President of ACLA.

This legislation encompasses the findings of a recent Government Accountability Office (GAO) Report to Congress, examining self-referral practices within Medicare for anatomic pathology services, which play a critical role in the diagnosis of many conditions, such as cancer. GAO concluded "that financial incentives for self-referring providers were likely a major factor driving the increase in anatomic pathology referrals." Specifically, GAO found that self-referring providers made an estimated 918,000 more anatomic pathology referrals than the amount made by non self-referring providers, costing an additional $69 million in Medicare expenditures in 2010. Further, GAO found that the increased number of referrals by self-referring clinicians were not a result of variances in "diagnosis, patient health status, other patient characteristics, or geography."

"On behalf of the laboratory sector, ACLA thanks Representative Speier for her strong leadership, as it will benefit patients, providers, and taxpayers through the elimination of the financial incentives for self-referral and decreased Medicare expenditures," said Mertz.

ACLA represents the nation's leading clinical laboratories.

SOURCE American Clinical Laboratory Association