Corporate Compliance

Study suggests physicians avoid Stark regulations

Compliance Monitor, April 25, 2007

A new study published in Health Affairs concluded that some physicians could be avoiding Stark regulations when they bill for advanced imaging services.

The study found that 33% of providers who billed for MRIs, 22% of those who billed for CT scans, and 17% of those who billed for PET scans could be classified as self-referrals.

Sixty-one percent of doctors who billed for MRIs and 64% of those who billed for CT scans didn't even own imaging equipment, according to the study.

If the referring physicians were prescribing appropriate tests and the charge for the test was no higher than rates at other facilities, physicians would probably avoid legal trouble, but researchers concluded that some arrangements would probably violate either federal or state self-referral laws.

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