More in-office labs are getting CAP accreditation even though the College of American Pathologists is vigorously lobbying Congress to exclude anatomic pathology from the in-office ancillary services exception to the Stark rules that prohibit self-referral. CAP states that when physicians order on the basis of financial interest, there is enormous potential for over-utilization of testing. Ironically though, more and more labs are getting CAP accreditation.
CAP clarifies its position on In-Office labs in October’s issue of Laboratory Economics…
In regard to in-office laboratory business arrangements, the CAP’s fundamental concern is that under the Stark in-office ancillary services self-referral exception, the incentive—regardless of accreditation—is to order and provide more testing services than are necessary, leading to overutilization of services and higher costs to the system. The incentives in these arrangements are misaligned, as is made clear by Congress’s current efforts to move away from these types of payment incentives.
The CAP accreditation process focuses on ensuring that ever lab we accredit meets the highest possible standards for operation under the law. Through the process, we verify what testing and services are provided, and ensure that they comply with CLIA. However, the accreditation process does not include scrutinizing or collecting information on a lab’s business arrangements.
Due to the requirement that CAP-accredited labs provide like-teams to participate in the accreditation of other labs, it is rare for an in-office lab to quality for CAP accreditation. However, it can happen if the lab meets all of CAP’s requirements, or if CAP review is requested by CMS, which does happen from time to time.