The author studied male Medicare beneficiaries who were potential candidates for prostate biopsies. Urologists who used the “in-office ancillary services” exception to refer patients to a facility in which the physicians have a financial interest billed Medicare for nearly 72 percent more specimens per prostate biopsy than physicians who did not self-refer. In addition, the cancer detection rate of self-referring urologists was 12 percentage points lower than non-self-referring urologists.
The author said the results suggest that self-referring urologists employing the “in-office” exception perform more prostate biopsies on men who are unlikely to have prostate cancer.
More Articles on Physician Self-Referrals:
Maryland Enforces Imaging Self-Referral Law After 5-Year Legal Battle
Study: Imaging Self-Referrals Associated With More Unnecessary Scans
Arkansas’ Baxter Regional Charges Management Firm With Self-Referral Violations
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