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February 3, 2015

Physician Self-referral: Regulation by Exceptions

Author Affiliations
  • 1The Warren Alpert Medical School, Brown University, Providence, Rhode Island
  • 2Venrock, Palo Alto, California
  • 3The Schaeffer Center for Health Policy and Economics at the University of Southern California, Los Angeles
JAMA. 2015;313(5):457-458. doi:10.1001/jama.2014.16600

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.

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