“Patients are at risk and Medicare is wasting money because of doctors who refer patients to facilities they own, the Government Accountability Office (GAO) said Wednesday,”  Sam Baker writes in The Hill’s Healthwatch.

“Congressional Democrats said the findings show that some doctors are lining their own pockets at the expense of patients and taxpayers.

“GAO found a steep rise in the number of self-referrals — doctors ordering tests at facilities where they or their family members have a financial stake. Critics argue that self-referral leads to wasteful spending because doctors will order unnecessary tests just to collect a payment from Medicare.

“ ‘The results of this report are eye opening,’ Senate Finance Committee Chairman Max Baucus (D-Mont.) said. ‘Self-referrals offer an incentive for providers to order more tests than they would otherwise. It’s clear they are driving up costs. Providers’ bottom lines shouldn’t be getting in the way of their patients’ care and best interests.’ ” — Sam Baker, The Hill, “GAO” Doctors’ Self-referrals cost Medicare more than $100m.”

Laws and regulations exist to prohibit self-referrals. These laws acknowledge that mis-aligned incentives exist, and attempt to correct for them. Why aren’t they working?

 

Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...