Federal legislators are pushing a ban on self-referral in radiation therapy in the wake of a U.S. Government Accountability Office report finding a massive jump in advanced radiation treatments for prostate cancer conducted at facilities owned by the referring physicians.
The GAO report found that the number of prostate cancer-related intensity-modulated radiation therapy, or IMRT, services performed by self-referring groups increased from about 80,000 to 366,000 between 2006 and 2010 while declining among non-self-referring groups. The report noted that self-referrers were less likely to refer patients for less-costly treatments such as radical prostatectomy or brachytherapy. It adds that the bill for prostate cancer-related IMRT services accounted for about 55% of the $1.27 billion Medicare spent on IMRT treatments in 2010.
“Factors such as age, geographic location and patient health did not explain the large differences between self-referring and non-self-referring providers,” the report concluded. “These analyses suggest that financial incentives for self-referring providers—specifically those in limited specialty groups—were likely a major factor driving the increase in the percentage of prostate cancer patients referred for IMRT.”
The report was requested by Sens. Max Baucus (D-Mont.) and Charles Grassley (R-Iowa) and Reps. Henry Waxman (D-Calif.) and Sander Levin (D-Mich.).