Federal Stark Law's In-Office Ancillary Services Exception Rule

 

Physicians and group medical practices rely on the Stark law’s in-office ancillary services exception rule and physician services exceptions to allow "within-practice" DHS referrals, to include laboratory testing.  This exception is of significant importance to a group medical practice’s internal activities and is used frequently as it allows physicians in medical practices to:

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• Make referrals for laboratory specimen within the medical practice as an in-office laboratory

• Furnish this testing to practice patients

• Bill Medicare and Medicaid for the services and

• Retain and use the revenues earned from providing the services within the group for payment of practice expenses and physician compensation

 

Due to this allowance, group practices are able to retain laboratory specimen within the practice at a single laboratory location, no matter how many clinic sites it might have in a geographical area.  The physician office laboratory, or POL, as it is commonly referred to, needs to meet all CLIA requirements for certification as a high-complexity laboratory.  These are the same clinical standards required of independent clinical reference laboratories. 

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Physicians and medical group practices have seen laboratories proliferate over the last decade, especially those for niche areas such as podiatric dermatology.  MDx Partners, LLC has designed its comprehensive turnkey laboratory development and oversight model to allow financially struggling group practices to retain this ancillary revenue stream and appropriately treat their patients with the highest level of diagnostic testing available in the market.  This shift of the lab revenue from independent reference labs to the practice will allow the healthcare providers and their staff to be more fairly compensated and potentially grow their service lines, further benefiting their patients.