President’s Budget for 2015 Recommends Exclusion of AP Services From the IOAS Exception

After many years of leading the charge against the self-referral of anatomic pathology (AP) services, the College of American Pathologists (CAP) is pleased that President Obama’s budget proposal for 2015, released March 4, for the first time recommends the exclusion of AP services from the “In-Office Ancillary Services” (IOAS) exception to the Stark Law. CAP’s strategy has been to provide reliable data, share individual case studies, and provide the facts to educate policymakers about the unintended consequences of including AP services under the IOAS exception. CAP made the case that closing the loophole protecting physicians who refer AP services to laboratories in which they, or an immediate family member, own or have a financial interest will generate significant Medicare savings, reduce unnecessary utilization, and benefit patient care. The IOAS exception was created to ensure patients could have easy access to a range of medical tests or services that inform diagnosis and treatment during the time of their physician visit such as strep and glucose testing, urinalyses and other clinical laboratory tests. It was never intended to include AP services, that involve a complex multi-step process and analysis of a tissue specimen procured as part of procedure to determine cancer or other diseases and conditions.