GAO Reports on Recent Increase in Self-Referrals for Advanced Imaging Services

The Government Accountability Office (GAO) recently conducted a study on the growth in referrals and expenditures for magnetic resonance imaging (MRI) and computed tomography (CT) services. The GAO found that self-referrals for MRIs and CTs had the greatest rate of growth from 2004 to 2010. In addition, the GAO noted that the increased use of imaging services presents a risk to patient health when the services are furnished unnecessarily. Medicare spending for self-referred advanced imaging services increased from $239 million in 2004 to $370 million in 2010. According to the GAO, self-referrals for MRI services increased by 80 percent from 2004 to 2010, while non-self referrals for the same services increased by only 12 percent. Given the rapid growth in self-referrals for advanced imaging services, GAO recommended that the Centers for Medicare & Medicaid Services (CMS) develop a mechanism to identify self-referrals on Medicare Part B claims for advanced imaging services. GAO further recommended that CMS reduce payments for self-referred imaging services and take steps to ensure the appropriateness of such services. The GAO report is available at: http://www.gao.gov/assets/650/648988.pdf.

Government Accountability Office. “Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions.” GAO-12-966. 31 Oct. 2012.