Physician Self-referral: Regulation by Exceptions

On June 2, 2014, the Government Accountability Office (GAO) released its fourth and final report on the national state of physician self-referrals.¹ Commissioned in 2010 by a bipartisan and bicameral congressional contingent, the GAO reports represent the latest audit of physicians who refer their patients to service facilities wherein they (or an immediate family member) have a financial interest.¹ Limited to self-referred services in the advanced imaging, anatomic pathology, radiation therapy, and physical therapy arenas, the GAO reports examined recent (2004-2010) growth rates in service utilization and the effect on Medicare Part B spending.¹ In this Viewpoint, we discuss the findings of the GAO, revisit the premise of physician self-referral, survey the relevant statutory and regulatory framework, and explore potential solutions to this vexing and costly challenge.