Medical Imaging War Pits Doctor vs. Doctor

The federal Accountable Care Act requires self-referring physicians to disclose their financial interest to patients and tell them about other facilities near them. Last year, the American College of Radiology says it unsuccessfully led an effort to put language in the federal ACA that would eliminate the in-office ancillary services, exception for advanced imaging and radiation therapy.

An article in the January issue of HealthLeaders Media, explains that Medicare payments for non-invasive diagnostic imaging (NDI), including MRI and computed tomography (CT ) scans are now higher to non-radiologists than to radiologists, citing an article in the Journal of the American College of Radiology.

Self-referral among non-radiologist physicians is behind the change, says David Levin, MD, of the department of radiology at Thomas Jefferson University Hospital in Philadelphia. Non-radiologists have become increasingly aggressive in their performance and interpretation of imaging, according to Levin. If policymakers, healthcare executives and other leaders want to control the costs of imaging, they need to either bar self-referrals or significantly restrict them, he said.  “This is what is driving up costs.”

Levin acknowledges the issue of self-referrals is “a political hot potato.”

No kidding. In Maryland, the issue won’t stop with the state medical board, or the high court. There is now legislation being considered in Maryland’s General Assembly, where lawmakers will debate whether to implement the self-referral exemptions that the orthopedists want. And there will be more debate, too, doctor vs. doctor.

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