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ASTRO applauds new GAO report on physician self-referral abuse
Date:8/2/2013

ASTRO Chairman Michael L. Steinberg, MD, FASTRO, called attention to the Government Accountability Office's (GAO) striking report released today, "Medicare: Higher Use of Costly Prostate Cancer Treatment by Providers Who Self-Refer Warrants Scrutiny," that details clear mistreatment of patients who trusted their physicians to care for their prostate cancer. Dr. Steinberg and radiation oncologists nationwide called on Congress to pass the "Promoting Integrity in Medicare Act of 2013" (PIMA), introduced earlier today by Rep. Jackie Speier (D-Calif.) and Rep. Jim McDermott (D-Wash.), that would address GAO's findings, result in better care for patients and save billions of dollars in Medicare that could offset the costs of repealing the Medicare physician payment formula (sustainable growth rateSGR).

The federal "Ethics in Patient Referrals Act," also known as the self-referral law, prohibits physicians from referring a patient to a medical facility in which he or she has a financial interest in order to ensure that medical decisions are made in the best interest of the patient without consideration of any financial gain that could be realized by the treating physician. However, the law includes an exception that allows physicians to self-refer for so-called "ancillary services," including radiation therapy. Over the years, abuse of the in-office ancillary services (IOAS) exception has diluted the self-referral law and its policy objectives, making it simple for physicians to avoid the law's prohibitions by structuring arrangements that meet the technical requirements of the law, thereby circumventing the intent of the exception. Numerous studies, including three recent GAO reports, have shown that physician self-referral leads to increased utilization of services that may not be medically necessary, poses a potential risk of harm to patients and costs the health care system millions of dollars each year.

Today's GAO report, "Medicare: Higher
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Contact: Michelle Kirkwood
michellek@astro.org
703-286-1600
American Society for Radiation Oncology
Source:Eurekalert

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