A study published in Health Affairs online provides the first empirical evidence concerning how often physicians are stretching federal and state laws--and perhaps breaking them--by referring patients to imaging providers with whom they have a financial relationship.
Study author Jean Mitchell, a professor of public policy at Georgetown University, gathered information on all providers who billed a large California insurer in 2004 for three types of diagnostic imaging scans--magnetic resonance imaging, computed tomography, and positron-emission tomography.
Mitchell found that nearly 33 percent of providers who submitted bills for MRI scans, 22 percent of those who submitted bills for CT scans, and 17 percent of those who submitted bills for PET scans were classified as “self-referral.” More than half of those who billed for MRI and for CT did not own the imaging equipment, but were involved in referral arrangements that might violate federal and state laws. Read the abstract.
