CMS Proposes Disclosure Requirements for MRI, CT and PET Services Provided Under Stark Act's In-Office Ancillary Services Exception

The Centers for Medicare and Medicaid Services (CMS) issued proposed regulations on June 25, 2010, that impact magnetic resonance imaging (MRI), computed tomography (CT) and position emission tomography (PET) services provided to Medicare patients under the Stark Act's In-Office Ancillary Exception. The proposed regulations require a physician referring a Medicare patient to in-office MRI, CT or PET services to i) inform the patient in writing that the patient may obtain the MRI, CT or PET services from a person other than the referring physician or the referring physician's group practice, and ii) include a list of alternate suppliers who provide the service being referred. The disclosure requirements will become effective on January 1, 2011, and not January 1, 2010, as earlier specified in the Patient Protection and Affordable Care Act (PPACA).

If the proposed disclosure requirements are not revised prior to their effective date, beginning on January 1, 2011, referring physicians will need to provide the above disclosure (a) in a manner to be understood by all patients; (b) at the time of the referral; (c) on a form that includes the names, addresses, telephone numbers and distances from the referring physician's office of at least 10 other MRI, CT and PET suppliers within a 25-mile radius of the referring physician; and (4) in a manner that obtains the signature of the patient and retains such documentation of the disclosure in the patient's medical record.

As illustrated above, the method of disclosure will be fairly burdensome on referring physicians. However, CMS is currently accepting comments on the proposed regulations through August 24, 2010. As a result, certain revisions to the disclosure requirements may occur prior to their effective date.

See the proposed regulations at http://edocket.access.gpo.gov/2010/pdf/2010-15900.pdf on pages 40248 and 40249.