Doctors who have a financial interest in a biopsy lab didn’t disappoint Government Accountability Office (GAO) auditors who checked to see whether owning a lab
caused an uptick in utilization – assuming auditors would have been disappointed if they didn’t find an increase, that is.
However, the specialists the GAO studied – gastroenterologists, dermatologists and urologists – obliged by increasing self-referrals of biopsy services by up to 58% within the year after they acquired a stake in a biopsy lab. That’s not very subtle, and it would be easy for an investigator to conclude the doctor is letting payments take precedent over medical necessity.
Folks who read
Medical Practice Compliance Alert and
Fraud and Abuse Answers know that self-referrals go beyond services offered by the ordering physician. A doctor who sends specimens to a lab owned by a close family member is also self-referring and could violate Stark law. So even though the GAO can’t nab doctors who break the law, this report reminds doctors that their billing practices are being inspected.