Instead of a change to the law, the GAO recommends these steps for the Centers for Medicare & Medicaid Services:
Kapoor says it is notable that despite the GAO's contention that self-referring is a cost driver, "it didn't recommend that the law be changed."
The GAO report, the second in a series, was prepared at the request of the Senate Finance Committee, which is leading a bipartisan effort to identify the effects of physician self-referral on the Medicare budget.
The first GAO report, released in October 2012, focused on self-referral for magnetic resonance imaging and computed tomography services. In that report, the GAO estimated that Medicare spent approximately $109 million more in 2010 than it would have without self-referrals. Future reports, expected this year, will cover self-referral in radiation therapy service and physical therapy services.
While Sen. Max Baucus (D-MT), the committee chair, has expressed concern about the report findings, he has not yet endorsed a legislative remedy.