The in-office ancillary services exception (IOASE) to the Stark law allows urologists to offer informed patients coordinated, efficient, and high quality care. Making services such as diagnostic imaging, clinical and anatomical laboratory testing, and radiation therapy available to patients, as strictly defined under the current Stark law, enables urologists to leverage their specialized training and detailed knowledge of a patient's medical history to coordinate an effective course of treatment. Under such conditions, patient compliance improves and the possibility for more swift and lasting therapeutic benefit increases. What's more, patient-centered care is being delivered in a less expensive, non-hospital setting. The in-office ancillary services exception has evolved over time and should be preserved. Policymakers should not be swayed by unsubstantiated claims from special interest groups that seek to preserve historical monopolies in the delivery of healthcare. These groups falsely claim that eliminating this key statutory provision in the self-referral law will produce savings for the Medicare program.
What You Should Know
Named for U.S. Representative Fortney Hillman "Pete" Stark, Jr. (D-CA, 1973-2013) the Stark laws were included in the Omnibus Budget Reconciliation Act of 1989 (Stark I) and 1993 (Stark II). Minor technical corrections were included in the 1994 amendments to the Social Security Act and are outlined in section 1877.
What the AUA is Doing
AUA Responses to Government Reports:
- AUA response to GAO Report, "Higher Use of Costly Prostate Cancer Treatment by Providers Who Self-Refer Warrants Scrutiny"
- AUA response to GAO Report, "Action Needed to Address Higher Use of Anatomic Pathology Services by Providers Who Self-Refer"
- Urologists Applaud Senators for Their Strong Support of Patient Access to Coordinated Care [pdf] December 5, 2013
- AUA, Sections Response to Congressional Inquiry on Possible Changes to Stark Law [pdf]
February 2, 2016
- Coalition for Patient Centered Imaging Comments to House and Senate Leaders on Administrative Proposal to Limit In-Office Ancillary Services Exception [pdf]
March 18, 2014
- Coalition for Patient Centered Imaging Letter to House of Representative Regarding the Promoting Integrity in Medicare Act of 2013 (H.R. 2914) [pdf]
August 12, 2013
- AUA Urges Lawmakers to Preserve In-Office Ancillary Exception [pdf]
June 24, 2013
- Letter from Energy & Commerce Committee to MedPAC [pdf]
- AUA Comments to MedPAC – In-Office Ancillary Use [pdf]
April 6, 2011
What You Can Do
Visit the AUA Advocacy Center for updates on alerts and calls to action on this issue.