Physician Groups Divided on GAO Self-Referral Report

Margaret Dick Tocknell, for HealthLeaders Media , July 29, 2013

The College of American Pathologists (CAP), the American Clinical Laboratory Association, and the American College of Radiology, are among the physician associations that want Congress to take immediate action to end the self-referral of anatomic pathology services.

The GAO report provides "irrefutable evidence that physician self-referral… contributes to widespread abuses, increased medical costs and over utilization," Gene Herbek, MD, FCAP, and the president-elect of the 18,000-member College of American Pathologists, said in a press statement.

In an e-mail exchange, Richard Friedberg, MD PhD, member of the CAP board of governors, and chair of the CAP council on government and professional affairs, dismissed Dr. Kapoor's clinical standards argument. "It is the ownership arrangement that accounts for the increase. The GAO study, as well as the study published last year in Health Affairs looked at the influences on the number of biopsies billed, and both found that physicians with a financial interest in providing the services billed for more services."

The only way to prevent the financial conflict of interest, Friedberg says, is to "remove anatomic pathology services from the in-office ancillary services exception. CAP believes Congress should act immediately to end self-referral of anatomic pathology services."

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1 comments on "Physician Groups Divided on GAO Self-Referral Report"

erowe (8/6/2013 at 5:39 PM)
The article neglected to mention that if the In Office Exception is eliminated, many more Medicare services will be provided in hospital outpatient departments, which costs much more (sometimes more than 2 times more) than services provided in a physicians' office. The GAO reports also ignored this consideration, so their conclusion that this self referral cost more money than if those physicians had to send the studies out, is invalid. The CAP has a very vested interest in this issue, because they will get all the business that is denied to the treating physicians who are "self referring".




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