Obama’s Budget Aims to Close Imaging Services Loophole

April 12, 2013

A proposal in the new Fiscal Year 2014 budget to close a loophole in the Stark self-referral law to unnecessary imaging scans and therapy aims to cut costs.

Imaging reimbursement would remain at current levels in the President Obama’s proposed budget for Fiscal Year 2014, but in an effort cut costs by closing a loophole in the Stark self-referral law, some services could soon require prior authorization.

The budget proposal calls for exclusion of advanced diagnostic imaging, radiation therapy, and physical therapy from the in-office ancillary services exemption (IOASE) to the Stark self-referral law. Although details are not yet available, it is reported that exceptions can be made in certain cases, according to the American College of Radiology.

The ACR said it is pleased that the current administration has not recommended further reductions in imaging reimbursement. “It is also truly gratifying to see that, after many years of persistent advocacy by ACR’s membership, leadership, and staff, in concert with our colleagues at the Alliance for Integrity in Medicare (AIM), the Obama administration is finally recognizing the importance of stopping abuse of advanced diagnostic imaging services through the Stark self-referral loophole,” ACR Chairman of the Board of Chancellors, Paul H. Ellenbogen, MD, FACR, said in a statement. “Nevertheless, we recognize that the policies outlined in the FY 2014 budget, especially those pertaining to self-referral, are not binding legislation and much more work is needed to be done before these changes are enacted into law.”

The Access to Medical Imaging Coalition (AMIC) didn’t agree with the proposals, however. Tim Trysla, AMIC’s executive director stated in a release, “President Obama’s budget would jeopardize patient access to care and important imaging services through burdensome prior authorization requirements. These policy recommendations are not supported by data, and ultimately, physicians, patients, and caregivers will pay the price.”

AMIC does not believe that the new policy would result in any cost savings and would add a middle-man between physicians and patients.