H.R. 5088. A job killer for pathologists?

[WEBB PINKERTON]

Will this bill be a job killer for pathologists?

"For anatomic pathology, GAO found that “self-referring providers likely referred over 918,000 more anatomic pathology services” than they would have if they were not self-referring, costing Medicare approximately $69,000,000 more in 2010 than if self-referral was not permitted."

https://www.congress.gov/bill/114th...+Integrity+in+Medicare+Act\""]}&resultIndex=1

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[LADoc00]

Yes and no. There are several ways to skin this cat even if self referral loopholes were outlawed. Realize technically they are illegal under Federal Law, this was Peter Stark's crowning achievement of his otherwise totally worthless career and before he was defeated in the last election by his own party's 20-something candidate.

What this is doing is closing the loopholes which they have talked about for YEARS yet done nothing.

An analogy would be California anti-gun laws. Every week they propose a law to ban this or that, so frequently that everyone who wants gun stuff has completely stocked up. And people have already found loopholes around the loopholes the CA politicians are planning to seal off.

If this did go into effect, every pathologist and clinician should already have a plan B in the hopper. Most commonly this would involve the pathologist owning the onsite lab and paying a lease fee to the clinician unrelated to volume...CMS/politicians/insurance companies cannot regulate such arrangements.

 

[WEBB PINKERTON]

If any future arrangements are unrelated to volume, volume would probably go down. Bad news for pathologists who need to feed the beast.

In the future, will pathologists have to "buy space" in order to get referrals? Is that what we get to look forward to next?

 

[LADoc00]

If any future arrangements are unrelated to volume, volume would probably go down. Bad news for pathologists who need to feed the beast.

In the future, will pathologists have to "buy space" in order to get referrals? Is that what we get to look forward to next?

Yah buy space unrelated to volumes...wink wink. Obviously no one will pay say 4K a month in rent for space while only getting 2K in specimens.

Regardless, the smart money will always find a way around the walls...

 

[WEBB PINKERTON]

In office pathology is implying that there are some competitors to them setting up 60 square feet labs.

http://iopathology.com/myth-of-the-60--lab.html

 

[yaah]

Well the other big question is how will this all shake out as payment/reimbursement models change to "population health" and not fee for service. Primary care docs will essentially be punished the more tests are ordered and the more biopsies that are done on each patient.