CMS Fails to Close Pathology Loophole in Self-Referral Rules

On October 9, CMS proposed updating the Medicare Physician Self-Referral Regulations, also known as the Stark Law. ASCP has long urged the Agency to close the loophole allowing other providers to profit on the pathology services they order. ASCP, a founding member of the Alliance for Integrity in Medicare (AIM), has urged CMS to remove anatomic pathology from the Stark Law’s In-Office Ancillary Services (IOAS) Exception. Unfortunately, CMS failed to do so in its Proposed Rule to the Medicare Physician Self-Referral Rules. As CMS has tried to discourage Medicare Fee-for-Service payment and encourage participation in value-based payment programs, ASCP and members of AIM have argued that the Agency would be better able to realize this goal if it discouraged providers from profiting on their referrals via the Self-Referral IOAS Exception. ASCP has argued that maintaining it provides a financial incentive for ordering providers to avoid transitioning away from Fee-for-Service.

ASCP plans to respond to the proposed rule during the formal comment period. Those interested in commenting on the proposed rule may do so here.

Other articles in the November 2019 ePolicy News:

• ASCP and the BOC Advocate for Better CLIA Personnel Standards
• ASCP Scores Major Victory with CMS on Laboratory Date of Service Policy
• Medicare Physician Fee Schedule Rule Mixed, But Trouble Lies Ahead
• ASCP Pushes CMS to Improve PFS QPP Rule for Pathologists
• Concerns About NGS Coverage Resonate with CMS
• ASCP Continues Patient Advocacy Efforts on Surprise Billing Legislation
• CMS Fails to Close Pathology Loophole in Self-Referral Rules

To read more articles from ePolicy News click here.

For more information regarding ASCP's advocacy initiatives and policy positions, please contact ASCP's Center for Public Policy at (202) 408-1110.