Budget Amendment ID: FY2015-S4-713

EHS 713

Self-Referral Study

Mr. Finegold moved that the proposed new text be amended moved that the bill be amended by inserting the following new section at the end thereof:-

“SECTION XX. The Center for Health Information and Analysis shall analyze Medicaid and private payer data necessary to identify disparity in the ordering and utilization of anatomic pathology services, as defined by M.G.L.A. 111 § 225, by physicians , or their family members, who have an ownership or financial interest in the laboratory or other entity performing or billing for such services under 42 USC § 1395nn(b), compared with the ordering and utilization of such services by physicians without such ownership or financial interests.  The center may require claims data to include information necessary to conduct this analysis, including, but not limited to: (1) physician ownership or financial interest disclosures, when such services are provided under 42 USC § 1395nn(b), (2) ordering physician medical specialty,  (3) place of service identification and (4) any other relevant information, as determined to be appropriate by the center through regulation.    Requirements for identification of ownership and financial interest shall not be construed by the Center to apply to anatomic pathology services ordered in academic medical centers or in a hospital for inpatients or outpatients of the facility.  The center shall report to the Legislature by July 1, 2015 for claims data examined for calendar year 2014 and, if feasible, include prior years for historical comparison.”