Prostate Cancer Self Referals

Austin Frakt with a chart on the increase in self-refering for Prostate Cancer IMRT treatments among Medicaid patients:

Some other facts from the GAO report:

  • Providers are not required to disclose that they self-refer.
  • IMRT is one of the more costly prostate cancer treatment options, but not clearly superior.
  • Other work has documented that physicians play a large role in determination of a patient’s prostate cancer treatment approach.
  • Other work has also suggests financial incentives may influence treatment decisions.
  • Differences between self-referring and non-self-referring providers shown above could not be explained by differences in age, geographic location, or health.

Prostate IMRT Services Performed by self-refering and non-self-refering

It looks like Stark Law has a restriction against self-refering for Medicare & Medicaid patients, but it looks like there are plenty of loopholes in the law. Clearly the law is failing in its intent, and I would hope that any future rewrites would include all patients in a self-referal restriction.