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OIG Audit of MR Services

The OIG just issued a report on Provider Relationship and the Use of Magnetic Resonance Under the Medicare Physician Fee Schedule.

This study focuses on the provision of the technical component of MR services. It presents data about all MR services and two subgroups of MR services: (1) those ordered by high users of MR and (2) those in which the orderer of the service had a connection to one or more of the parties involved in providing the service (hereafter referred to as connected services).
Connected services were provided differently than services that were not connected. One-quarter of MR services paid under the MPFS in 2005 were connected services, which were associated with high use. Compared to all other services, connected services were more likely to be ordered by orthopedic surgeons. Multispecialty groups performed and were paid for half of connected services, compared to only one-quarter of all other services. The IDTF and diagnostic radiology specialties played a smaller role in connected services compared to all other services. Finally, connected services were more likely than other services to have been billed as technical component only, to have had payment reassigned, and to have been billed through a provider other than a radiologist.
The complexity and limited transparency with which these services are provided warrants continued attention to ensure that services are reasonable, necessary, and compliant with Medicare statutes and regulations.

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This page contains a single entry from the blog posted on September 25, 2008 4:26 PM.

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