Pathologists Urge AMA To Keep Anti-Markup, Lab Billing Sections in Code of Ethics

The College of American Pathologists (CAP) and other groups representing pathologists are opposing proposed changes to the AMA's Code of Ethics that they feel will weaken the code by removing sections on laboratory billing and anti-markup of pathology services. CAP leadership recently spoke during a hearing before the AMA Council on Ethical and Judicial Affairs (CEJA), which launched a major project to review and update the code in 2008. Specifically, the CEJA is proposing to remove a section of the policy that requires disclosure to the patient or payer of the actual cost of a laboratory service. CAP urges that the original language be retained, which states, in part, that "the referring physician's bill to the patient should include the actual charges for the laboratory services, including the name of the laboratory, as well as any separate charges for the physician's own professional services."The council is also proposing changes to "Services by Multiple Physicians" by deleting provisions that 1) require direct billing to the patient by the physician providing the service and 2) prohibiting markup of another physician's work. CAP argues that the current policy "helps protect all physicians from adverse commoditization of our services" and that the current language should be retained. The CEJA also proposed to rescind its policy on "Laboratory Services," which prohibits markup of lab services and directs that patients have the benefit of any discounts. CAP argues that payment for anatomic and clinical pathology services should be made only to the person or entity who performed or supervised the service, except for referrals between laboratories independent of a physician's office.

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