AMGA: Proposed self-referral bill would hurt patients

The American Medical Group Association (AMGA), a trade association focused on improving healthcare throughout the United States, has issued a statement in opposition to legislation being considered by Congress that would limit self-referrals in numerous specialties, including imaging.

HR 2143, the Promoting Integrity in Medicare Act (PIMA), was introduced by Reps. Jackie Speier (D-California) and Dina Titus (D-Nevada) on April 9 and would prevent self-referrals related to four key areas: advanced imaging services, radiation therapy, anatomic pathology and physical therapy. According to AMGA, this bill would “impede integrated, coordinated patient care and providers’ ability to reduce the cost of care.”

“Restricting multispecialty medical groups and integrated delivery systems from providing advanced imaging services is contrary to AMGA members’ mission of providing value-based care,” Jerry Penso, MD, MBA, AMGA president and CEO, said in a prepared statement. “This legislation not only will impact the timeliness of diagnosing our patients. It also will negatively affect population health efforts and create more access burdens for patients seeking efficient, cost-effective treatment.”

The proposed policy, AMGA added in its statement, could have a particularly hurtful impact on patients in rural areas where imaging provider options may be limited.

On the other hand, the Alliance for Integrity in Medicare (AIM), a group comprised of several medical societies, supports PIMA. The American Society for Radiation Oncology (ASTRO), a member of AIM, has issued a statement applauding the bill’s introduction.

“Inappropriate self-referral undermines ASTRO-supported efforts to move Medicare toward quality- and value-based reimbursement,” ASTRO Chair Paul Harari, MD, said in the group’s statement. “Alternative payment models, for example, will not be successful if incentives remain for overutilization of medical services. We applaud Rep. Speier and Rep. Titus for their leadership in introducing legislation that closes the self-referral loophole, drives needed payment reforms and reduces waste—all while protecting patients.”