Physician Self-Referral: Banned, But Surprisingly Common

A study published yesterday on the Health Affairs Web site 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.

“Laws enacted during the early 1990s to curb physician self-referral were a major step toward addressing the concerns about these arrangements; however, they contain exceptions that could enable self-referral to reappear,” writes study author Jean Mitchell, a Georgetown University professor of public policy. “The findings presented here, which are based on a comprehensive list of providers who billed a large private insurer in California for advanced imaging procedures in 2004, indicate that prohibition exceptions have enabled self-referral to persist, but in new forms” tailored to fit the exceptions.

You can read Mitchell’s article at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.26.3.w415

Health Affairs is pleased to make this article freely accessible to all readers for only two weeks.