As the leading advocate for the specialty of urology, the American Urological Association (AUA) supports initiatives that benefit patients by providing coordinated, continuous care and management of urologic disease. These services exist to improve patient care through physician oversight of the quality of care and can help integrate and coordinate the patient treatment plan. Therefore, the AUA supports the exception to the Stark Law (the in-office ancillary services exception), which allows urologists to provide ancillary services when they provide the services as part of their practices. When urologists choose to provide such services, the AUA believes that urologists should comply with current federal and state laws and regulations. Following are ethical guiding principles for urology practices that provide ancillary services as part of their practices:

1. Patients should be provided with information about their condition including all appropriate treatment options.
2. Patients should be advised that they are entitled to seek a second opinion from another licensed health care provider specializing in their disease or area of treatment (e.g., radiologist, pathologist, oncologist) in accordance with the principles of shared decision-making.
3. All treatment advice or referrals should be based on objective, medically acceptable and supported recommendations.
4. The provision of an ancillary service should be transparent and in the patient's best interest. Patients should be reassured that their urologic care will not be disrupted or penalized if they seek an alternate physician supplier or provider of ancillary services.

AUA Board of Directors, January 2013
AUA Board of Directors, February 2013 (Revised)