End client billing in illinois

[kruppe]

Ok guys now is the time to put our "surplus" numbers to the test.
There's a vote on Wednesday to end client billing in Illinois... most clinicians there take home at least 70% of the TC/PC for anatomic pathology while providing zero of the service work- literally nothing. They just send the lab the specimens and give the lab 30% or less of what they bill for the lab service.
There's a link below for witness slips supporting a bill introduced to end this practice.
You don't have to be a physician to enter these witness slips, you just have to have a residence in Illinois. It takes 2 minutes to fill out. If you've got any family or friends in Illinois... get them on this.
No complaining abt leadership e.t.c. This is all of us individually doing something to help ourselves.
The clinicians there are fighting this furiously but this is the first time the bill has got this far.


http://my.ilga.gov/WitnessSlip/Crea...2484&CommitteeHearings-page=1&_=1398547780111

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[Whiskeyjack]

Ok guys now is the time to put our "surplus" numbers to the test.
There's a vote on Wednesday to end client billing in Illinois... most clinicians there take home at least 70% of the TC/PC for anatomic pathology while providing zero of the service work- literally nothing. They just send the lab the specimens and give the lab 30% or less of what they bill for the lab service.
There's a link below for witness slips supporting a bill introduced to end this practice.
You don't have to be a physician to enter these witness slips, you just have to have a residence in Illinois. It takes 2 minutes to fill out. If you've got any family or friends in Illinois... get them on this.
No complaining abt leadership e.t.c. This is all of us individually doing something to help ourselves.
The clinicians there are fighting this furiously but this is the first time the bill has got this far.


http://my.ilga.gov/WitnessSlip/Crea...2484&CommitteeHearings-page=1&_=1398547780111

70% for nothing. That kind of galling greed is almost admirable in a Gordon Gecko kind of way. Geez.

 

[Substance]

I bet the finely-castrated pathologists and their ilk will not sign this thing with their names on it, for fear of losing business if it doesn't pass.

 

[WEBB PINKERTON]

It's hard to believe Illinois still allows client billing. Where is CAP headquarters again? Oh yea, Northfield Illinois.....

The legislation that gets rid of client billing is too narrow in my opinion. It's only AP codes and the line between CP and AP is blurring big time. In the future, these laws will be worthless as microscopy is replaced with molecular. Look no further than what just happened to Cytopathology. The pap test is on the verge of being replaced with HPV testing. You can't client bill screening a pap BUT it is perfectly fine to client bill HPV testing. I'd rather see legislation that is looking toward the future.

Still, it is nice to get a victory. We got rid of client billing back in 2011 in my area. It felt pretty darn good.

 

[univlad]

Anyone know the result of the vote?

 

[LNsquasher]

Had already passed the senate. It passed in the house subcomittee during the most recent vote this week. Will be voted on by full house next. People I've talked to are very optimistic for its passage and it will likely be fast tracked for governor's signature. Long overdue.

 

[LNsquasher]

For your reference:
http://www.ilga.gov/legislation/BillStatus.asp?DocNum=1630&GAID=12&DocTypeID=SB&SessionID=85&GA=98

 

[Tissue issue]

Interesting. I noticed this in the bill - "Provides that the clinical laboratory or physician shall not charge, bill, or otherwise solicit payment for anatomic pathology services unless the services were rendered personally by the clinical laboratory or physician or under the clinical laboratory's or physician's direct supervision." I'm wondering what is to prevent a GI or urology group from saying that the pathologist they hired is under their direct supervision?

 

[Whiskeyjack]

Absolutely nothing I think. Though I think some could make the argument that in order to supervise a specialist (pathologist) one would have to be a specialist.
This bill isn't to kill pod labs. Its to prevent clinicians profiting off work they have absolutely no capital/liability risk in-ala client billing. In house ancillary ap services are still permitted as per the Clarke law exemptions but the laws as well as reimbursement cuts will soon catch up to that I'm sure and it'll be foolhardy for clinicians to make the investment in that croaking gravy train.

 

[Tissue issue]

Thanks for the explanation. It bothers me that the sentence doesn't end after "Provides that the clinical laboratory or physician shall not charge, bill, or otherwise solicit payment for anatomic pathology services unless the services were rendered personally by the clinical laboratory or physician". What the @#$^ does it mean that a pathologist is signing out cases "under direct supervision"?

 

[univlad]

Does anyone have any experience as to what has happened in other states after laws prohibiting mark ups for AP services were passed? Did your dermatologists/GI docs/urologists continue to send specimens to the larger labs and receive client bills, passing the "new savings" to their patients or did you see a return of specimens to your hospital pathologists who sent their own bills and took on the risk of nonpayment?

 

[Whiskeyjack]

Does anyone have any experience as to what has happened in other states after laws prohibiting mark ups for AP services were passed? Did your dermatologists/GI docs/urologists continue to send specimens to the larger labs and receive client bills, passing the "new savings" to their patients or did you see a return of specimens to your hospital pathologists who sent their own bills and took on the risk of nonpayment?

I think the whole point of the law is to end client billing so to the last two questions: legally no and hopefully yes respectively.
To the first question I'm just as interested though I fear fraud will always find a way.

 

[WEBB PINKERTON]

Since physicans can't client bill AP codes any longer, it just causes more pressure to reduce the cost for CP tests. The big labs still find ways of making inducements despite these laws. It won't make much difference for your practice.

The physician offices will demand that you lower the cost for CP codes. These laws arent thorough enough. AP and CP tests are going overlap more and more due to technology. I dont know why pathologists and others keep acting like *******. Push to end client billing for ALL lab testing for god's sake.

 

[Ziehl-Neelsen]

Article in the St. Louis Post Dispatch yesterday about the practice of client billing. It smacks of a public relations push by Show Me State pathologists to gain favor for legislation that would end the practice. I hope it brings some awareness to the issue (though knowing St. Louisans, the article was probably considered a waste of space that could have been used for the umpteenth analysis of the Cards-Cubs game).

http://www.stltoday.com/business/lo...cle_42834b6f-1fac-59e7-9a33-2ffca39f136d.html

 

[kruppe]

So it seems that the bill is no longer about direct billing but an anti mark up bill.
Not as good as direct billing law would be but at least it might curtail the ridiculous profit clinicians make on AP services they don't perform.
Also the language in the bill allows for billing for "actual costs for transportation and specimen collection" even though these costs are almost ubiquitously shouldered by the labs. Another loophole that will be exploited en masse.
Maybe the administrative costs of doing the billing without the profits they are used to will deter clinicians... but they will find a way to shift that cost onto the labs I'm sure.
Sigh...Everything changes... Everything stays the same.

 

[yaah]

So it seems that the bill is no longer about direct billing but an anti mark up bill.
Not as good as direct billing law would be but at least it might curtail the ridiculous profit clinicians make on AP services they don't perform.
Also the language in the bill allows for billing for "actual costs for transportation and specimen collection" even though these costs are almost ubiquitously shouldered by the labs. Another loophole that will be exploited en masse.
Maybe the administrative costs of doing the billing without the profits they are used to will deter clinicians... but they will find a way to shift that cost onto the labs I'm sure.
Sigh...Everything changes... Everything stays the same.

True, if they have to account for the $ spent on package, shipping, etc, then they can't ask the lab to cover that cost anymore.

 

[univlad]

It also says that they can bill a handling fee, but that fee must be coded as a handling fee, not part of the lab fee. I doubt many insurance companies will pay that.

 

[LADoc00]

70% OF THE PC?! (spits soda all over the screen)

What idiot Pathology groups agreed to that??

Who is the bigger fool? The fool who leads the fool or the fool who follows??

 

[univlad]

What has been the response of clinicians in Illinois since the law has passed? Have people noticed clinicians doing anything different with their biopsies in their area?

 

[Torsed]

Who is going to enforce it? Does it take tattle tailing to the Medical Board? Do they even care?