GAO Finds Self-Referrals Hike Medicare Spending; Providers Reject Limits

Posted: Oct. 31, 2012
Physicians are driving up Medicare costs with self-referrals, according to a Government Accountability Office report that both Democrats and Republicans say shows Medicare should not incentivize unnecessary tests. However, providers say restricting in-office imaging would hurt patients.

Medicare paid $109 million more in 2010 for MRIs and CT services than it would have absent self-referral incentives, the report found. GAO investigated self-referrals for magnetic resonance imaging services and computed tomography services from 2004 to 2010. It found that the number of self-referred MRI services increased by more than 80 percent compared to a 12 percent increase for non-self-referred MRI services. For CT services, the growth of self-referred services more than doubled, while non-self-referred CT services increased by about 30 percent.

Sens. Max Baucus (D-MT) and Chuck Grassley (R-IA) as well as Reps. Pete Stark (D-CA), Sandy Levin (D-MI) and Henry Waxman (D-CA) issued a joint release stating that the report shows Medicare should not incentivize unnecessary tests.

The American Association of Orthopaedic Surgeons says in-office imaging is a useful tool that leads to more patients following treatment plans and to improved outcomes.

“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,” AAOS states in a release. “We believe that any restriction on this convenience would threaten the quality of care being delivered to our patients.” -- John Wilkerson