Section 6003 of the Patient Protection and Affordable Care Act (PPACA), which is the 2010 Healthcare Reform Act, imposes a new disclosure requirement for in office ancillary service referrals of imaging services.  Section 6003 requires that referrals of MRI, CT, PET, and other designated health services as specified by the secretary, must be accompanied by a written notice that the patient may obtain services from other suppliers in the area, a written list of whom must be provided. 

There is considerable controversy regarding the effective date of this requirement.  The statute states that it shall apply to services furnished on or after January 1, 2010.  Commentators have suggested that the statute cannot be applied until the secretary defines certain items, the least of which is the “area in which such individual resides.”