GAO to study link between physician self-referral, Medicare imaging costs

Following recent scrutiny of the high utilization of costly advanced medical imaging paired with health reform's focus on diminishing physician self-referral, the American College of Radiology is looking for data on how physician self-referral of such procedures affects Medicare spending.

In requesting that the General Accountability Office perform the study, the ARC cited the March 2009 Medicare Payment Advisory Commission report to Congress, which found that the number and Medicare cost of self-referred MRI and CT scans grew at nearly double the rate of that performed by other providers from 2006-2008.

The ACR argues that CMS should remove MRI, CT, positron emission tomography and radiation therapy procedures from the "in-office ancillary exception" to federal law, which allows providers to refer patients to in-office ancillary services in which they hold a financial interest.

"Elected officials, government agency staff, and referring physicians need to support these steps to eliminate financially driven self-referral and make sure that every patient receives the right scan or treatment, at the right time, for the right indication," stated an ARC press release.

To learn more:
- Read this report in Becker's Hospital Review
- Read what the American College of Radiology has to say

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