For the first time, President Obama has proposed excluding anatomic pathology (AP) services from the in-office ancillary services exception (IOAS) to the Stark law. The proposal is included in the president’s 2015 budget sent to Congress on March 4. While the administration previously has proposed to remove advanced imaging, physical therapy, and radiation therapy from the IOAS exception, AP services were never included. According to the Office of Management and Budget (OMB), the estimated savings to the Medicare program for removing all four services would be more than $6 billion over 10 years. 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, urinalysis, and other clinical laboratory tests. According to the College of American Pathologists (CAP), it was never intended to include AP services that involve a complex multistep process and analysis of a tissue specimen procured as part of a procedure to diagnose cancer or other diseases and conditions. The process can almost never be completed with results available at the time of the patient’s office visit. CAP has long…
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