A new study published in Health Affairs suggests that some physicians may be dodging Stark regulations when billing for advanced imaging services. The study, which used data from an unnamed California insurer, found that 33 percent of providers who billed for MRIs, 22 percent of those billing for CT scans and 17 percent of those who billed for PET scans could be classed as self-referrals. These physicians are avoiding the appearance of conflict by leasing or payment-per-scan referral arrangements, researchers said. In fact, 61 percent of doctors who billed for MRIs and 64 percent of those billing for CT scans didn't own imaging equipment. If the referring physicians were prescribing appropriate tests, and the charge for the test was no higher than rates at other facilities, physicians would probably avoid legal trouble, but researchers concluded that some arrangements would probably violate either federal or state self-referral laws.
To find out more about the study:
- read this Health Affairs abstract