The Circuit Court for Montgomery County, Maryland, upheld a decision prohibiting a physician from referring patients for tests on an MRI machine that is owned or leased by the physician.

AAOS Now

Published 12/1/2007

Maryland court upholds self-referral decision

On Oct. 16, 2007, the Circuit Court for Montgomery County, Maryland upheld a decision of the Maryland Board of Physicians (Board) prohibiting a physician from referring patients for tests on a magnetic resonance imaging (MRI) machine that is owned or leased by the physician.

The litigation began in 2006 when the Board interpreted a 1993 statute (known as the Maryland Self-Referral Law) to prohibit this type of MRI referral. Because the Board had not previously taken a position during the 13 years after the passage of the Self-Referral Law, insurance carriers indicated that they would seek refunds from physicians for payment for MRIs conducted in violation of the Self-Referral Law.

After the Board ruling, 13 physician groups filed the suit (Potomac Valley Orthopaedic Associates, et al v. Maryland State Board of Physicians) with the Circuit Court, claiming that the Board misinterpreted the plain meaning of the Self-Referral Law. The American Association of Orthopaedic Surgeons (AAOS) filed an amicus brief in support of the physician groups arguing that the Board’s ruling is contrary to the policy determination of the federal government and medical community. The AAOS also argued that the ruling is unnecessary because it places a blanket ban on misconduct that is already prohibited by the Board. The Circuit Court disagreed by focusing on the specific language in the Self-Referral Law and ultimately deferring to the Board’s judgment.

Joining the AAOS in the amicus were the American Association of Neurological Surgeons, Society of Cardiovascular Computed Tomography, Mid-Maryland Musculoskeletal Institute, American Urological Association, Inc., and American College of Surgeons.

The decision (available online at www.mbp.state.md.pdf) is being appealed.