The below information was provided by Matthew Schulze, a manager of state affairs in the ASCP Washington, DC, office in 1999, as posted in 1999.
Direct-Access Testing: A State-by-State Analysis Officials at the state level were recently consulted to determine state policies on direct-access testing. States allowing for direct access, also known as direct laboratory access, allow individuals, upon request, to receive laboratory tests and procedures absent a physician’s referral… Twenty-six states indicated they allow for patient direct authorization of laboratory testing in some shape or form. Of these 26 states, most indicate that there is no state law prohibiting this practice. Only a few states have set limits on the types of tests that may be performed. Laboratories are not required to perform the requested procedures, state officials indicated, and may set their own policies with regard to performing tests based solely on a individual’s Direct Access State Allowed? Notes/Applicable Legal Citations request. Several states noted that while state law allowed for direct-access testing, it was their understanding that few, if any, laboratories provided laboratory testing without a physician’s referral. In states allowing direct-access testing, laboratories may provide test results to the requesting individual. However, numerous state officials cautioned that laboratory personnel should be aware that interpreting the results for the patient may constitute unauthorized practice of medicine. Laboratories in states not allowing direct access may still be able to perform some patient-requested testing. Several state officials noted that physician standing orders, which are essentially open-ended physician referrals, could be used to enable a laboratory to perform some patient-requested tests. Laboratorians should be aware that state policies differ on the authority that standing orders provide.
Matthew Schulze is manager of state affairs in the ASCP Washington, DC, office.
Questions? For more information, contact the ASCP Washington Office at (202) 347-4450.