A new twist on IOP

[AZpath]

Dermatologists in my area sold out to a venture capital company that specializes in buying small practices. (Many of the practices are 1-3 providers.)
Most had no pathology in house. Now they send all there work to an " IOP lab".

The path lab is in a centralized location in another state owed by the practice.
That's a new one on me. Medicare rule makers likely never anticipated this scenario.
The last IOP rules were put out around 2008 to address pod labs. I think this is legal currently.

Btw, it is doing pretty good on their contracts. They fowarded an AZ patient and Texas BCBS approved payments at 4 x medicare.

I can't get 1.25x MC for Arizona BCBS. I have the EOB so this is real.

I guess everything is really bigger in Texas after all.

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[WEBB PINKERTON]

Forefront has been buying up the derms in my region. Path lab is in Wisconsin I believe. It has left a mark on many local path groups. Huge volume heading out of state.

 

[cmz]

Wonder if there is some sort of Stark law violation because it states that "you have to perform the interpretations in a location where each of the referring physicians provides substantially the full range of his or her services to patients." With that said, I am pretty sure you can get away with performing interpretations at a central location. If you want to bill TC, that might be an entirely another story all together... that's what pricey healthcare legal counsel is for, right?

 

[AZpath]

Wonder if there is some sort of Stark law violation because it states that "you have to perform the interpretations in a location where each of the referring physicians provides substantially the full range of his or her services to patients." With that said, I am pretty sure you can get away with performing interpretations at a central location. If you want to bill TC, that might be an entirely another story all together... that's what pricey healthcare legal counsel is for, right?

I believe there are two safe harbors
Either location of full range of service

Or

The pathologist does at least 75% of professional services for the practice