On Aug. 1, Rep. Jackie Speier (D-CA) introduced the "Promoting Integrity in Medicare Act," according to a press release from the American Physical Therapy Association (APTA), Alexandria, VA. This measure seeks to remove physical therapy and other healthcare services from the in-office ancillary services (IOAS) exception from the federal Stark laws, also commonly known as self-referral. If enacted, it would effectively eliminate financial incentives from the physician-referral process. The APTA and its partners in the Alliance for Integrity in Medicare, or AIM Coalition, strongly support this move to exclude these services from the IOAS exception.
The self-referral law generally prohibits physicians from referring Medicare patients to entities in which they have a financial interest. It seeks to ensure medical decisions are made in the best interest of the patient on the basis of quality, diagnostic capability, turnaround time, and cost without consideration of any financial gain that could be realized by the referring physician. Originally intended for same-day services such as X-rays and blood draws, the IOAS exception allows physicians to bill the Medicare program for procedures that are meant to be integral to the physician's services and offered for patient convenience.
"Unfortunately, using the exception in a manner not originally intended provides physicians with incentive to refer patients for services that may not always be necessary or typically provided on the same day of an office visit," the press release continued. "This not only increases utilization of services but also Medicare costs. Physical therapy services clearly do not meet the intent of the exception and self-referral by physicians has the potential to increase costs. Physicians and physical therapists have a longstanding professional relationship that serves patients well without the need for adverse financial ties or relationships."
The argument over physician-owned physical therapy services (POPTS) has raged in the profession for years now. This latest development is certainly a boost to the cause of those who oppose POPTS. On which side of the issue do you stand? What do you believe the future holds for POPTS?