Self-Referred Biopsies Cost Taxpayers Millions, GAO Reports

Physicians who prepare and examine tissue samples within their own practices, or who use services in which they have a financial interest, report higher use of these services, which could be driving up costs to Medicare, according to the Government Accountability Office.

Modern Healthcare: Self-Referrals Costing Medicare Millions, GAO Reports
Physicians who prepare and examine tissue samples in their own practices rather than referring them to labs report higher use of the services, suggesting that the financial incentives behind self-referrals may be driving the increase, according to the Government Accountability Office. In a new report (PDF), the GAO concludes that Medicare would have saved $69 million on anatomic pathology services in 2010 if self-referring physicians performed biopsies at the same rate and referred the same number of services per procedure as non-self-referring providers (Lee, 7/15).

CQ HealthBeat: Doctor-Referred Biopsies Too High, GAO Says
The number of times doctors order anatomic pathology tests, more commonly known as biopsies, when they have a financial stake in the testing is increasing dramatically, with the Government Accountability Office estimating that in 2010, Medicare paid $69 million it could have saved had the number of self-referrals not been so high (7/16).

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