Dec. 14, 2012 – The Centers for Medicare & Medicaid Services (CMS) is considering Government Accounting Office (GAO) recommendations to review self-referred advanced imaging services by self-referring providers to assure the appropriateness of the referrals.
The GAO recently completed a study and determined that the number of self-referred advanced imaging services, such as magnetic resonance imaging (MRI) and computed tomography (CT) services, grew at a substantially greater rate than non-self-referred services.
The study also showed that referrals of MRI and CT services substantially increased after physicians began to self-refer after either acquiring imaging equipment or joining a practice that already self-refers. The GAO stated that their findings suggest that the increase in the average number of referrals by physicians who became self-refers was not due to a general increase in the use of imaging services among all providers but that financial incentives for self-referring were a major factor.
The GAO stated that “to the extent that these additional referrals were unnecessary, they pose unacceptable risks for beneficiaries, particularly in the case of CT services, which involve the use of ionizing radiation that has been linked to an increased risk of developing cancer.” Unnecessary referrals also place an unjustifiable burden on the Medicare program.
Click here to read the entire GAO report and HHS’ response.