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Report finds self-referred imaging services cost Medicare $109 million

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Self-referral incentives for physicians for CT and MRIs cost Medicare $109 million in 2010, according to a report released by the Government Accountability Office.

Between 2004 and 2010, physician self-referred MRI services increased by 80%, as opposed to a 12% increase for MRI services that were not self-referred, according to the report. In contrast, non-self-referred CT services increased by 30%, while self-referred CT services doubled.

Additionally, expenditures for self-referred services also increased. Expenditures for self-referred MRIs increased by 55% during the time period, while non-self-referred MRI services decreased by 8.5%. Self-referred CT expenditures increased by 67%, while non-self-referred expenditures grew by 5%, according to the report.

“The results of this report are eye opening,” Sen. Max Baucus (D-MT), chairman of the Senate Finance Committee, stated in a U.S. Senate Committee on Finance press release. “Self-referrals offer an incentive for providers to order more tests than they would otherwise. It’s clear they are driving up costs. Providers’ bottom lines shouldn’t be getting in the way of their patients’ care and best interests.”

In a statement responding to the report, John R. Tongue, MD, president of American Association of Orthopaedic Surgeons, said that self-referred imaging services are timely and accessible.

“The AAOS believes that the provision of in-office imaging services is critically important for musculoskeletal patients and can lead to greater patient adherence to treatment plans and improved outcomes,” Tongue stated in a press release. “Significant technological advances have been made in our field so that patients can receive timely and accessible screenings from the comfort of their doctor’s office. We believe that any restriction on this convenience would threaten the quality of care being delivered to our patients.”

Reference:

www.finance.senate.gov/newsroom/chairman/download/?id=4797b76f-64e4-4330-afe0-258bb0a4fc44