The Maryland Court of Appeals has upheld (PDF) an earlier decision by the Montgomery County Circuit Court that found the state's self-referral law prohibits a physician from providing patients with diagnostic services within the physician's practice group.
Md. appeals court upholds ban on diagnostic self-referrals
Twelve medical practices specializing in orthopedics, urology, radiation oncology and emergency medicine had appealed a December 2006 declaratory ruling by Maryland's state physicians board that the circuit court later affirmed. The declaratory ruling arose out of two formal petitions—one by CareFirst Blue Cross and Blue Shield and the other by the Injured Workers' Insurance Fund—that asked the board to rule on the propriety under the Maryland self-referral law regarding referrals from physicians for MRI scans when the physician has a financial interest in the performance of the scan.
"There seems to be little question that the Legislature intended by this bill to substantially restrict the practice of self-referring, especially self-referrals of MRI scans, CAT scans and radiation therapy services,” the court held in its opinion. "The self-referral law thus created a broad and pervasive prohibition against self-referrals not only by physicians (as did the federal law), but also by all other healthcare providers."
The American College of Radiology lauded the opinion, calling the decision a major victory for quality patient care and patient choice.
"Since its inception in 1993, the Maryland statute has been vigorously attacked by its opponents," Dr. John Patti, chairman of the American College of Radiology Board of Chancellors, said in a news release following the court's decision. “This decision should enable the state board to enforce the law's limits on MRI, CT and radiation therapy performed by self-referring physicians," Patti said, adding that the association had supported the Maryland Radiological Society in the litigation by submitting an amicus brief to the appeals court.
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