A new law effective Jan. 22, 2011, increases payment disclosure requirements for physicians who order laboratory tests and directly pay the lab for the tests. It was passed unanimously by the state Senate and House of Representatives.
The Pennsylvania Medical Society (PAMED) was able to have House Bill 2521 amended on the House floor so that it follows American Medical Association (AMA) and PAMED policy regarding pathology service disclosure.
In Pennsylvania, physicians can either direct bill or client bill for pathology services. With direct billing, the provider or entity that provided or supervised the lab service directly receives payment.
With client billing, the physician who ordered the lab service pays for the service and then collects payment from the patient or insurer. This allows the physician to, for instance, charge full price for the laboratory service even if they received a discount.
AMA and PAMED policy calls for physicians who client bill to disclose the name of laboratory, the amount charged by the laboratory for each test, and the amount of the physician’s acquisitions or processing charge in bills to patients or insurers.
Similar disclosures are required in a number of states, including Delaware, Ohio, Maryland, and New Jersey.