A bill that would close the so-called loophole for some types of self-referral of advanced imaging went in front of the House again this week.

On Wednesday, California Democrat Jackie Speier introduced "Integrity in Medicare Advanced Diagnostic Imaging Act of 2011" (H.R. 1476). Speier introduced a similar bill two years ago.

The bill aims to end the in-office ancillary exceptions to self-referral for CT, MRI and PET scans included in the Stark Laws, legislation first passed in the 1990s that's meant to crack down on doctors ordering tests or services on equipment they own.

The bill would not affect ultrasound, fluoroscopy, X-rays or imaging done for planning radiation therapy treatment.

The American College of Radiology has long championed ending the Star Law exceptions for advanced imaging, and has pledged to find more cosponsors for what it calls "common sense" legislation.

In general, the Stark Laws prevent doctors from referring Medicare patients to facilities they have a financial stake in. However, there are exceptions to the rule. The in-office ancillary exceptions allow doctors to refer "designated health services," such as imaging, at centers they have a stake in as long as it's done by a doctor in the same physician group at the same offices.

Opponents of the exceptions believe that self-referral by doctors on equipment they own leads to overutilization of imaging and the waste of health care dollars on unnecessary treatments or exams.

"It is terrible to think that this loophole is being abused to enrich doctors while their patients are being unnecessarily exposed to radiation," Speier said while introducing the bill, according to an ACR statement. "This bill puts patients first and potentially saves the government billions of dollars in wasteful expenditures."

Earlier this year, new regulations to the in-office ancillary exceptions took effect. At the time of an in-office referral, the Centers for Medicare and Medicaid Services now requires referring doctors to give patients a written notice of at least five rival groups within a 25-mile radius of the doctor's office.

More Industry Headlines