KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Doctor Self-Referrals For Advanced Imaging Cost Medicare $100M In 2010

According to a Government Accountability Office report, doctors who referred patients for tests involving advanced imaging machines that they or a family member owned cost Medicare more than $100 million in 2010.

Modern Healthcare: Self-Referral Boosts Medicare Imaging Costs: GAO
In 2010, it's estimated that providers who self-referred patients for advanced imaging made about 400,000 more referrals than they would have had they not had a financial interest in the imaging equipment and that these referrals cost the Medicare system an additional $109 million, according to a new Government Accountability Office report. In 2010, some 6.8 million magnetic resonance imaging and computed tomography services for Medicare beneficiaries were conducted in a physician office or independent diagnostic testing facility, according to the report, and this accounted for about 23 percent of all such services delivered to Medicare fee-for-service beneficiaries (Robeznieks, 10/31).

The Hill: GAO: Doctors' Self-Referrals Cost Medicare More Than $100M
Patients are at risk and Medicare is wasting money because of doctors who refer patients to facilities they own, the Government Accountability Office (GAO) said Wednesday. Congressional Democrats said the findings show that some doctors are lining their own pockets at the expense of patients and taxpayers. GAO found a steep rise in the number of self-referrals -- doctors ordering tests at facilities where they or their family members have a financial stake. Critics argue that self-referral leads to wasteful spending because doctors will order unnecessary tests just to collect a payment from Medicare (Baker, 10/31).

CQ HealthBeat: New Findings Suggest Doc Overuse Of Imaging To Boost Income
With lawmakers on the prowl for pay-fors to offset the costs of the next Medicare "doc fix," a new Government Accountability Office study is coming out at a bad time for the medical imaging industry and the doctors who own imaging gear. The study, released Wednesday, found that doctors with a personal financial stake in ordering MRIs or CT scans -- either because they or a family member owned or were part owners of the imaging equipment -- issued 400,000 more referrals for such tests in 2010 for Medicare patients than they would have without such a stake. In that year alone, the additional referrals cost Medicare about $109 million, the report said (Reichard, 10/31).

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