Maryland Court of Appeals to rule on imaging self-referral case

Maryland Appeals Court expected to maintain previous verdicts against self-referrals. Image Source: American Academy of Orthopaedic Surgeons

Last week, the Maryland Court of Appeals heard oral arguments on whether it should uphold or reverse a trial judge’s 2007 ruling that the state medical board properly interpreted the contentious physician self-referral law.  

In 2006, 14 medical practices filed suit against Maryland’s State Board of Physicians, claiming that state authorities misread the law and several exemptions within it that allow in-office referrals for ancillary services, including imaging tests. In December 2007, the trial court judge, Judge DeLawrence Beard, agreed with the board that the law’s ancillary services exception does not allow orthopedic referrals for MRI or CT scans because the definition specifically excludes all physicians except radiologists from performing those scans.

An attorney representing several orthopedic practices argued that the court of appeals should overturn the Beard ruling. However, the Assistant Attorney General (AG), arguing for state’s Board of Physicians, said that the appellate court should affirm the trial court’s decision. Counsel for the Maryland Radiological Society, which intervened in the case as a party, similarly argued in support of the current law.   

American College of Radiology (ACR) representatives, who were in attendance to hear the arguments, said that the court appeared more inclined toward the AG’s and Maryland Radiological Society’s positions. Several judges seemed skeptical of the orthopedic practices’ claim that the trial court and medical board had misconstrued the scope of the self-referral law and what the Maryland Legislature intended when it enacted the law.

The court of appeals likely will deliver an opinion within the next four to six months, according to the ACR.