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Support the Promoting Integrity in Medicare Act and Help Curb Referral for Profit in PT

Tuesday, May 28, 2019   (0 Comments)
Posted by: Debbie Sullivan
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On April 9, 2019, Congresswoman Jackie Speier (D–CA) introduced the Promoting Integrity in Medicare Act of 2019, H.R. 2143.  This bill closes the in-office ancillary services (IOAS) exception under the physician self-referral prohibition, commonly known as the Stark Law.   The Promoting Integrity in Medicare Act removes physical therapy, as well as advanced imaging, radiation oncology, and anatomic pathology from the IOAS exception.  If passed, this legislation will help curb unnecessary utilization, decrease spending, and eliminate conflicts of interest in physician referrals under Medicare.


The Stark laws were enacted to reduce conflicts of interest in the Medicare system.  The Stark laws generally prohibit physicians from referring Medicare patients to entities in which they have a financial interest. This requirement is to ensure that medical decisions are made in the best interest of the patient without consideration of any financial gain that could be realized by the treating physician through self-referral.  The in-office ancillary services (IOAS) exception to the Stark laws was created to allow physicians to self-refer and bill the Medicare program for typical same day services, such as x-rays, while the patient was in the physician office. Unfortunately, this exception was inappropriately expanded to include many services and procedures that are either not same-day services or are too advanced to be completed during the patient’s initial visit. Physical therapy is one such service that is currently falls under the IOASE.

You Can Help - Take Action Today!

APTA has long been opposed to referral for profit (RFP) in physical therapy, also known as physician-owned physical therapy services (POPTS).  Please click here to send an email or letter to your Representative asking them to co-sponsor the Promoting Integrity in Medicare Act (H.R. 2143).

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