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Corporate Author United States. Government Accountability Office.

Title Medicare [electronic resource] : higher use of advanced imaging services by providers who self-refer costing Medicare millions : report to congressional requesters.

Imprint [Washington, D.C.] : U.S. Govt. Accountability Office, [2012]


Location Call No. OPAC Message Status
 Axe Federal Documents Online  GA 1.13:GAO-12-966    ---  Available
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).
"September 2012."
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.
Magnetic resonance imaging -- Economic aspects -- United States.
Tomography -- Economic aspects -- United States.
Medicare fraud -- United States -- Prevention.
Medicare -- economics.
Diagnostic Imaging -- economics -- United States.
Diagnostic Imaging -- ethics -- United States.
Medicare -- legislation & jurisprudence.
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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