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Olga Deshchenko, DOTmed News Reporter | September 03, 2010
DeNucci's audit cited the 2007 Special Commission on Ambulatory Surgical Centers and Medical Diagnostic Services' report, suggesting that the commonwealth implement the commission's recommendations.
According to that report, a loophole in the federal Stark Law, "can potentially be exploited through business models in which doctors ostensibly lease the equipment and employees of an imaging center at the time of service, thus holding no technical ownership in the practice. There is evidence of such leasing arrangements in Massachusetts."
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Some state employees speculate that Mass. legislation that would strengthen the Stark Law has been largely ignored by the commonwealth because of strong lobbying efforts by the medical imaging industry.
DeNucci's audit recommended implementing state legislation that would "piggyback" both the federal Stark Law and the anti-kickback statute.
Briere said the agency is well aware of the self-referrals issue that was discussed in the report.
"We're aware that Massachusetts doesn't have a state version of the Stark Law," he said. "There has been legislation filed to do that and has yet to go anywhere."
As for the discrepancies in state and federal Medicaid reimbursement rates, Briere said the agency found it "a little surprising."
"It does seem to make sense that if the federal government is paying a lower reimbursement rate that Massachusetts piggyback onto that," said Briere.
The Massachusetts Office of Medicaid expressed its support for the auditor's attempts to control MassHealth costs.
"We share the auditor's commitment to controlling health care costs in the Medicaid program wherever possible and have initiated many successful efforts to realize cost savings for the commonwealth," the spokeswoman wrote. " In 2009 and 2010 alone, we have implemented $1.275 billion in savings initiatives within the Medicaid program while protecting access to vital services for our members."
Briere said he hopes the report helps shift the focus to the importance of state legislation that would curb self-referrals in advanced imaging.
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