Published 5/1/2007

AAOS files amicus brief on Maryland MRI issue

AAOS argues ruling unnecessary because it is a blanket ban on conduct prohibited by State Board
On March 23, 2007, the American Association of Orthopaedic Surgeons (AAOS) filed an amicus brief in Potomac Valley Orthopaedic Associates, et.al. v. Maryland State Board of Physicians in the Circuit Court of Montgomery County, Md. The American Association of Neurological Surgeons, the Society of Cardiovascular Computed Tomography, the Mid-Maryland Musculoskeletal Institute, the American Urological Association, Inc., and the American College of Surgeons joined the AAOS in the brief.

The case is an appeal of a declaratory ruling (Ruling) of the Maryland State Board of Physicians (Board). Although the Maryland Self-Referral Law was passed in 1993, the Board had not taken a position on whether it applied to physicians who referred patients for tests on a magnetic resonance imaging (MRI) machine that is owned or leased by the physician until 2006. At that point, the Board ruled that the Self-Referral Law did apply to these physicians. As a result of the Ruling, insurance carriers have indicated that they will seek refunds from physicians for payment for MRIs conducted in violation of the Self-Referral Law.

According to Andrew N. Pollak, MD, of the R Adams Cowley Shock Trauma Center, about 25 orthopaedic practices in the state may be affected by the ruling. “It appears as if this issue was triggered by a complaint from a radiology group to the Maryland Physician’s Board,” said Dr. Pollak.

The 13 physician groups that filed the suit in December 2006 claimed that the Board misinterpreted the plain meaning of the Self-Referral Law. AAOS argues in the amicus that the Ruling is contrary to the policy determination of the federal government and the view of the medical community. The AAOS also argues that the Ruling is unnecessary because it is a blanket ban on conduct that is already prohibited by the Board.

“We are hopeful that the Board’s ruling will be overturned, but the legal question is too close to call at this point,” commented Dr. Pollak.

The Maryland Radiological Society has intervened in the appeal and is also expected to file a response.