HHS Targets In-Office Ancillary Services

The proposed fiscal 2016 budget for the US Department of Health and Human Services (HHS) includes a change to existing exceptions in the physician self-referral (Stark) law that could affect some orthopaedic practices. Beginning in 2017, HHS would prohibit many in-office referrals for “therapy services, advanced imaging, and anatomic pathology services.” (See pages 68 and 76 of the budget, specifically.) Such services are currently allowed to enhance patient convenience, but HHS claims that they “are rarely furnished on the same day as the related physician visit.” The HHS budget also points to “evidence that suggests that this exception may have resulted in overutilization and rapid growth of certain services,” and it estimates that implementing this restriction would save more than $6 billion over 10 years.

In a blog post from the law firm of Duane Morris, attorney Matthew Jones says, “While the current political climate in Washington leaves the fate of HHS’s proposed budget far from certain, physicians must once again be on the alert for increased limitations on their ability to provide in-office ancillary services.”

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