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Focus on Healthcare: Self Referral Situations For Physicians

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Two recent reports from the US Government Accountability Office (GAO) and the Office of Inspector General (OIG) stress the importance of understanding self referral situations.

The GAO report found that the rate of Intensity-Modulated Radiation Therapy (IMRT) used by self referring urologists grew from 13.1% to 32.3% from 2005 to 2010 as compared with growth of 14.3% to 15.6% among non-referring urologists for the same period.  There has been some disagreement about the validity of the data and this may stem from the question of who should perform radiation therapy procedures, oncologists or urologists.
November 6, 2013

Two recent reports from the US Government Accountability Office (GAO) and the Office of Inspector General (OIG) stress the importance of understanding self referral situations.

The GAO report found that the rate of Intensity-Modulated Radiation Therapy (IMRT) used by self referring urologists grew from 13.1% to 32.3% from 2005 to 2010 as compared with growth of 14.3% to 15.6% among non-referring urologists for the same period.  There has been some disagreement about the validity of the data and this may stem from the question of who should perform radiation therapy procedures, oncologists or urologists.

The OIG report found that as many as 20% of the 179,000 Medicare funded spinal surgeries in 2012 involved devices that were provided from companies in which doctors had an ownership position, known as physician owned distributorship (POD’s). There is some question as to whether the POD’s are indeed the low cost providers and save hospitals money by using them.

The take away is clear. There is still a risk in any situation that involves relationships between doctors and their related business entities. Appropriate professionals should be consulted.

 

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