White Budget: Radiology Provisions Include Self-Referral, Prior Authorization, Research Funds

Radiologists should be encouraged that the Administration, for the fourth year in a row, has included provisions in their budget to close the in-office ancillary services (IOAS) exception to the Ethics in Patient Referrals Act commonly referred to as the Stark law. The budget stipulates that, starting in 2018, advanced imaging, radiation therapy, anatomic pathology and physical therapy services would be removed from the IOAS exception. The Obama Administration would only permit these four services to be self-referred within clinically integrated practices that are required to demonstrate cost containment. In total, closure of the IOAS exception is expected to produce slightly more than $4.9 billion in savings over 10 years. Meanwhile, radiologists continue to be frustrated by the Obama Administration’s annual effort to establish a Medicare prior authorization program. Although the Administration did not specifically cite a prior authorization policy strictly for advanced imaging services as it has in past budgets, the president did call for a broader, prior authorization policy that affects all Medicare fee-for-service procedures.