ACR Applauds Maryland Ruling to Uphold State Self-Referral Law

Urges Other States to Adopt Safeguards Against Self-Referral

WASHINGTON, Jan. 25, 2011 /PRNewswire-USNewswire/ -- The American College of Radiology applauds and supports the Maryland Court of Appeals decision to uphold provisions of the state's self-referral law prohibiting physicians from referring patients for MRI, CT and radiation therapy services to providers within their own group practice. The ruling represents a major victory for quality patient care and patient choice.

"The Maryland court has provided a tremendous public service with this ruling. Studies have shown that there is very little, if any, patient benefit to self-referral of advanced imaging and radiation therapy. Instead, the practice often results in significant unnecessary utilization of imaging, unwarranted radiation exposure, lower quality of care and increased cost that is ultimately passed on to patients," said John A. Patti, MD, chair of the American College of Radiology Board of Chancellors. "The Maryland law is a model to which other states should look — to maintain quality, curtail inappropriate utilization, and ensure that health care dollars are spent effectively."

The Maryland high court ruled that the state Board of Physicians was entitled to administrative deference on interpreting and applying the self-referral statute to it's administers. The court also clarified that the law's "direct supervision" exception, which is limited to referrals to 'outside entities,' requires that the referring physician be "personally present within the treatment area when the service is being performed" and must personally provide that service or directly supervise it.

"Since its inception in 1993, the Maryland statute has been vigorously attacked by its opponents. This decision should enable the state board to enforce the law's limits on MRI, CT and radiation therapy performed by self-referring physicians," Patti added. "ACR is proud of its role in assisting the Maryland Radiological Society (MRS) during the entire litigation by submitting an amicus brief to the court of appeals and contributing to the chapter's legislative efforts to keep the law intact."

Notably, the court also concluded that the state's legislative history clearly showed the General Assembly intended to exclude MRIs and CTs from the 'in-office ancillary services exception.' The court further highlighted that the state General Assembly rejected four legislative attempts since 2007 to weaken the statute. Such "persistent inaction" confirmed the legislature's intent about the law's scope.

The Maryland decision comes on the heels of recent movement on self-referral at the federal level. The ACR spearheaded an effort to gain language in the new health care reform law that would eliminate the in-office ancillary services exception for advanced imaging and radiation therapy. Congress stopped short of this goal but the new law does require self-referring physicians to disclose their financial interest to patients and inform them of other facilities near them at which they could have the exam or procedure performed. This is a first step, at the national level, toward addressing the quality and cost associated with self-referral of advanced medical imaging exams and radiation therapy procedures.  

"The College continues to push for further legislative action that would discourage financially motivated self-referral and to educate lawmakers at all levels of government regarding sound imaging and radiation therapy policy," said ACR Chair Patti. "The ACR understands that the Maryland law's opponents almost certainly will mount an aggressive effort to repeal or amend the statute.  However, ACR remains committed to assisting the MRS in upholding Maryland's sensible approach to self-referral and to working with lawmakers, government agencies, and other stakeholders to enact sensible self-referral policy nationwide," added Patti.

SOURCE American College of Radiology