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.

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.