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.
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.