Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Health Care & Wellness Committee

HB 2605

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Summary of Bill

Prohibits physicians from directly or indirectly charging, billing, or soliciting payment for anatomic pathology services unless they were rendered directly by, or under the direct supervision of, the physician.

Background:

Current law (chapter 19.68 RCW) permits a referring physician to charge patients for actual services performed by the physician for the patient, including reimbursement for the actual charges of pathologists performing services on referral. The referring physician is prohibited from charging any amount greater than the actual amount billed to the referring physician by the pathologist, and charges for additional services by the referring physician for the patient. This is currently no requirement that a referring physician disclose in the bill to a patient or payor the actual cost of the pathology service. This makes it difficult to apply and enforce the provisions of chapter 19.68 RCW relating to prohibiting the markup of pathology services.

The federal Medicare program prohibits physicians from billing Medicare for laboratory work they did not supervise or perform. Sixteen states currently require direct billing for pathology services.

Summary of Bill:

Clinical laboratories or physicians providing pathology services for patients must present a bill only to a patient, a third-party payor, a hospital or clinic ordering the service, the referring laboratory or a government agency or its agent. Physicians cannot bill, directly or indirectly, for anatomic pathology services unless they were rendered personally or under the direct supervision of the physician. A violation of these requirements would be addressed under chapter 18.130 RCW, the Uniform Disciplinary Act.