Physicians Providing MRI/CT/PET Services In-office Must Provide Written Disclosure to Medicare Patients

Pursuant to the healthcare reform bill that was signed into law by President Obama on March 23, 2010 (“the Patient Protection and Affordable Care Act” or “the Act”), physicians who furnish MRI, CT or PET tests within their practices for their patients are now required to provide their patients with a written disclosure at the time of the referral.

By way of brief background, the Stark Law prohibits physicians from referring Medicare patients for certain “designated health services” (including MRI, CT, and PET) to an entity with whom the referring physician (or any of his/her immediate family members) has a direct or indirect financial relationship, unless an exception is met. Physicians and entities who furnish designated health services within their practices typically rely upon Stark’s In-Office Ancillary Services Exception (the “IOASE”) in order to avoid running afoul of the Stark Law.

Notably, Section 6003 of the Act adds a requirement that physicians who furnish MRI, CT or PET testing services for their Medicare patients in reliance on the IOASE inform the patient in writing at the time of the referral that the patient may obtain the MRI, CT or PET test from other suppliers of the services. Physicians are also required to provide a written list of suppliers who furnish those services in the area where the patient resides. Section 6003 allows the Secretary of Health and Human Services to require similar notices for other categories of imaging services that fit within the definition of designated health services.

This new disclosure provision of the Act applies to services furnished on or after January 1, 2010 (but the disclosure requirement appears to have taken effect on March 23, 2010, the date President Obama signed the bill into law). Section 6003 of the Act contemplates that regulations will be issued which implement the new disclosure requirement.

However, physicians who furnish MRI, CT, or PET tests pursuant to the IOASE, should immediately begin to provide the required written disclosure to their Medicare patients.

If you have any questions on this new disclosure requirement, including what terms should be included in the disclosure notice, please call (248-996-8510) or contact Adrienne Dresevic, Esq. or Carey F. Kalmowitz, Esq. We will continue to keep you apprised of any future regulations that are expected to be implemented on this issue.