Congressional Committees Ask GAO to Study Effects of Physician Self-Referral of Advanced Medical Imaging on Medicare Spending

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At the request of the American College of Radiology, House Energy & Commerce Chair Henry Waxman (D-Calif.), Ways & Means Committee Chair Sandy Levin (D-Mich.) and Ways & Means Subcommittee on Health Chair Pete Stark (D-Calif.) recently called on the General Accountability Office to perform a study regarding the effects of physician self-referral of advanced medical imaging and radiation therapy treatments on Medicare spending, according to a release by the American College of Radiology.

The ACR cited the March 2009 Medicare Payment Advisory Commission report to Congress when requesting the GAO study. That report found overall Medicare imaging utilization growth for 2006-2008 was 2 percent or less nationally — at or below the growth rate of other major physician services. However, the number of self-referred MRI and CT scans in the Medicare system as well as Medicare spending on self-referred MRI and CT grew at nearly double the rate of that performed by other providers.

The ACR argues that government regulation is needed to address financially driven self-referral and contends that MRI, CT, positron emission tomography and radiation therapy procedures are not ancillary services. Further, the ACR argues that CMS should remove such services 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.

Read the ACR release on the GAO study on physician self-referral.

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