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Bill Introduced in Congress to Close Stark In-Office Exemption for Certain Imaging Procedures
California Congresswoman Jackie Speier has introduced a bill in the US House of Representatives that would close the in-office ancillary services exception to the Stark legislation. Rep. Speier has a long history of action on this topic and authored a similar bill while she was a member of the California Assembly in the early nineties. The CRS supports Rep. Speier's bill now at a time when elected officials in Washington are debating various health care bills and looking for potential savings. Closing the Stark loophole will curtail the wasteful overimaging that occurs when doctors self-refer their patients to imaging centers in which they have an ownership stake. The CRS believes that these targeted reductions in the use of imaging, combined with other smart controls on imaging volume, such as appropriateness criteria and mandatory accreditation, will be preferable to additional unit reimbursement reductions, such as those enacted as part of the Deficit Reduction Act of 2005.
Please review the followoing four background articles that should be required reading for all Radiologists and can be distributed to regulators and elected officials to bring them up to speed on this complex issue.
Your help will be greatly appreciated. We must act quickly, as the Congress hopes to finalize a bill by the end of summer.
State Begins to issue Warrants for Some Payments
Reprinted below is the notice form DHCS on the issuance of warrants ( IOUs) for some state payments. At this point it does not include Medi-Cal and Healthy Families since those programs also involve federal funds. State only program like CCS or GHPP are subject to warrants. At this point there are funds to pay Medi-Cal claims but as this budget stalemate continues those funds could also be exhausted. Those of you providing services to CCS or mammography screening services under the Every Woman Counts program will see warrants issued for those payments.
Registered Warrants Issued to Specific Providers
As requested by the State Controller's Office (SCO), the Department of Health Care Services (DHCS) has made the necessary changes to implement Registered Warrants to certain health care providers and programs beginning July 2, 2009, until further notice.
Registered Warrants, or IOUs, are legal negotiable instruments that are paid with interest. All payments to be registered must be in the form of a Controller's (paper) warrant. As a result, Electronic Fund Payments (EFT) to providers will be discontinued and Registered Warrants payments will be issued. Please note that the programs listed below may have both Medi-Cal and Non Medi-Cal funding associated with them. The issuance of a Registered Warrant will only apply to the non-Medi-Cal portion of the claim payments. The affected programs are as follows:
- California Children's Services (CCS)
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- Cancer Detection Programs: Every Women Counts (CDP: EWC)
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- Child Health and Disability Prevention (CHDP) General Fund Only
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- Children's Treatment Program (CTP)
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- Expanded Access to Primary Care (EAPC)
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- Genetically Handicapped Persons Program (GHPP)
The payments to the programs noted above will not be issued on July 1, 2009 as previously announced, but instead will be issued as Registered Warrants on July 2, 2009. The Registered Warrants will be mailed to the "Pay To" addresses on file. Providers are urged to verify the accuracy of their information, including the "Pay To" address, to minimize misdirected or returned warrants. Providers may call the Telephone Service Center (TSC) at 1-800-541-5555 from 8 a.m. to 5 p.m., Monday through Friday, except holidays, to verify this information. Any changes to the information on file will require completion of the applicable Provider Enrollment Division (PED) form.
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