Exemption protects in-office imaging

Congress acknowledged that physician self-referral causes an inherent conflict of interest that can be resolved only by banning the practice. But it did not include blanket restrictions in the Ethics in Patient Referral Act of 1989. The law, authored by Rep. Fortney "Pete" Stark (D-CA), is generally referred to as Stark I.

Because radiologists do not have the authority to refer patients, they were exempted when the law was applied to medical imaging services in 1995. Those amendments are called Stark II.

Exemptions were also stipulated for in-office imaging and other ancillary services performed in physicians' offices. They apply when in-office imaging meets specific supervision, location, and billing requirements. -JMB