The new healthcare laws signed by President Obama on March 23rd and 30th, and specifically the Patient Protection and Affordable Care Act (PPACA), includes a significant modification to the "in-office ancillary services" exception of the Stark Law. Physicians who refer patients for MRI, CT or PET services, to an entity in which the referring physician has a financial interest, including the physician's own office or medical group, must now provide written notice to the patient of the patient's ability to utilize an alternative supplier. Additionally, the notice must include a list of alternative suppliers. This amendment not only applies to referrals to a separate entity, but it also applies to referrals within a group practice.