Description |
1 online resource (iii, 46 p.) : col. ill. |
System Details |
Mode of access: World Wide Web. |
Note |
Title from title screen (viewed on Dec. 31, 2012). |
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"September 2012." |
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QR code for online version of document included on title page. |
Summary |
Medicare Part B expenditures--which include payment for advanced imaging services--are expected to continue growing at an unsustainable rate. Questions have been raised about self-referral's role in this growth. Self-referral occurs when a provider refers patients to entities in which the provider or the provider's family members have a financial interest. GAO was asked to examine the prevalence of advanced imaging self-referral and its effect on Medicare spending. This report examines (1) trends in the number of and expenditures for self-referred and non-self-referred advanced imaging services, (2) how provision of these services differs among providers on the basis of whether they self-refer, and (3) implications of self-referral for Medicare spending. GAO analyzed Medicare Part B claims data from 2004 through 2010 and interviewed officials from the Centers for Medicare & Medicaid Services (CMS) and other stakeholders. Because Medicare claims lack an indicator identifying self-referred services, GAO developed a claims-based methodology to identify self-referred services and expenditures and to characterize providers as self-referring or not. |
Bibliography |
Includes bibliographical references. |
Note |
"GAO-12-966." |
File Type |
Text in PDF format. |
Subject |
Medicare -- Economic aspects.
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Magnetic resonance imaging -- Economic aspects -- United States.
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Tomography -- Economic aspects -- United States.
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Medicare fraud -- United States -- Prevention.
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Medicare -- economics. |
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Diagnostic Imaging -- economics -- United States. |
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Diagnostic Imaging -- ethics -- United States. |
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Medicare -- legislation & jurisprudence. |
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Fraud -- prevention & control -- United States. |
Added Title |
Higher use of advanced imaging services by providers who self-refer costing Medicare millions |
Running Title |
Medicare self-referral of advanced imaging services |
Gpo Item No. |
0546-D (online) |
Sudoc No. |
GA 1.13:GAO-12-966 |
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