because patients must return for physical therapy treatments. (16) In an April 2018, European Urology article authored by leading urologists about Medicare beneficiaries with prostate cancer diagnoses, researchers found, Urologists practicing in single-specialty groups with an ownership interest in radiation therapy are more likely to treat men with prostate cancer, including those with a high risk of noncancer mortality. . This suggests that urologists practicing in single-specialty groups with an ownership interest in radiation therapy are more likely to treat, and even potentially overtreat, patients with IMRT than those affiliated with a multispecialty practice or a group without an ownership stake. (17) In a January 2019, JAMA Oncology article, authors systematically reviewed 18 studies to assess physicians’ response to reimbursement incentives on cancer care delivery across various clinical settings. Across the studies, the authors consistently found that the ability to self-refer for radiation oncology services was associated with increased use of radiation therapy . (18) Those services intended to be covered under the IOAS exception are not affected by this legislation. (19) The exception to the ownership or investment prohibition for rural providers in the Stark rule is not affected by this legislation. (b) Purposes The purposes of this Act are the following: (1) Maintain the in-office ancillary services exception and preserve its original intent by removing certain complex services from the exception—specifically, advanced imaging, anatomic pathology, radiation therapy, and physical therapy. (2) Protect patients from misaligned provider financial incentives. (3) Protect Medicare resources by saving billions of dollars. (4) Accomplish the purposes described in paragraphs (1), (2), and (3) in a manner that does not alter the existing exception to the ownership or investment prohibition for rural providers. 3. Limitation on application of physicians’ services and in-office ancillary services exceptions