Journal of the American College of Radiology
Volume 6, Issue 6 , Pages 390-392 , June 2009

Why the In-Office Ancillary Services Exception to the Stark Laws Needs to Be Changed—And Why Most Physicians (Not Just Radiologists) Should Support That Change

  • David C. Levin, MD

      Affiliations

    • Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania
    • HealthHelp, Inc, Houston, Texas
    • Corresponding Author InformationDavid C. Levin, MD, Thomas Jefferson University Hospital, Department of Radiology, 1090 Main, Philadelphia, PA 19107
    • ,
  • Vijay M. Rao, MD

      Affiliations

    • Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania
    • ,
  • Alan D. Kaye, MD

      Affiliations

    • Department of Radiology, Bridgeport Hospital, Bridgeport, Connecticut

References 

  1. Greeson TW, Zimmerman HM. Policy brief: imaging services and increasing health care costs: is limiting self-referral the answer to controlling costs?. AJR Am J Roentgenol. 2004;183:A9–A11
  2. Berlin L, Berlin JW. Leasing imaging facilities to referring physicians: fee shifting or fee splitting?. Radiology. 2005;234:44–48
  3. Levin DC, Rao VM. Turf wars in radiology: the overutilization of imaging resulting from self-referral. J Am Coll Radiol. 2004;1:169–172
  4. Levin DC, Rao VM. Turf wars in radiology: updated evidence on the relationship between self-referral and the overutilization of imaging. J Am Coll Radiol. 2008;5:652–656
  5. Gazelle GS, Halpern EF, Ryan HS, Tramontano AC. Utilization of diagnostic medical imaging: comparison of radiologist referral versus same-specialty referral. Radiology. 2007;245:517–522
  6. Hillman BJ, Joseph CA, Mabry MR, Sunshine JH, Kennedy SD, Noether M. Frequency and costs of diagnostic imaging in office practice—a comparison of self-referring and radiologist-referring physicians. N Engl J Med. 1990;323:1604–1608
  7. Hillman BJ, Olson GT, Griffith PE, et al. Physicians' utilization and charges for outpatient diagnostic imaging in a Medicare population. JAMA. 1992;268:2050–2054
  8. Mitchell JM. The prevalence of physician self-referral arrangements after Stark II: evidence from advanced diagnostic imaging. Health Aff. 2007;26:w415–w424Available at: http://content.healthaffairs.org/cgi/content/abstract/hlthaff.26.3.w415. Accessed December 28, 2007
  9. Mitchell JM. Utilization trends for advanced imaging procedures (Evidence from individuals with private insurance coverage in California). Med Care. 2008;46:460–466
  10. Levin DC, Rao VM, Parker L, Frangos AJ, Sunshine JH. Ownership or leasing of MRI facilities by nonradiologist physicians is a rapidly growing trend. J Am Coll Radiol. 2008;5:105–109
  11. Levin DC, Rao VM, Parker L, Frangos AJ, Sunshine JH. Ownership or leasing of CT scanners by nonradiologist physicians: a rapidly growing trend that raises concern about self-referral. J Am Coll Radiol. 2008;5:1206–1209
  12. Levin DC, Intenzo CM, Rao VM, Frangos AJ, Parker L, Sunshine JH. Comparison of recent utilization trends in radionuclide myocardial perfusion imaging among radiologists and cardiologists. J Am Coll Radiol. 2005;2:821–824
  13. US Government Accountability Office. Medicare Part B imaging services (Rapid spending growth and shift to physician offices indicate need for CMS to consider additional management practices). http://www.gao.gov/highlights/d08452high.pdfAccessed January 7, 2009
  14. Baucus M. The Baucus plan. http://finance.senate.gov/healthreform2009/finalwhitepaper.pdfAccessed December 15, 2008
  15. Levin DC, Rao VM, Kaye A. Turf wars in radiology: recent actions against self-referral by state governments, commercial payers, and Medicare—hope is on the horizon. J Am Coll Radiol. 2008;5:972–977

PII: S1546-1440(09)00020-9

doi: 10.1016/j.jacr.2009.01.008

Journal of the American College of Radiology
Volume 6, Issue 6 , Pages 390-392 , June 2009

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