• Facebook
  • Twitter
  • Youtube
  • Instagram
  • LinkedIn
  • Rss
  • Store
  • Donate
NCCS - National Coalition for Cancer Survivorship
  • About
    • Our Mission
    • Our History
    • The 1986 Club
    • Our Team
      • Policy Advisors
    • Employment
    • Partnerships
    • Financial Information
  • Policy
    • Quality Cancer Care
    • Access to Care
    • Health Equity
    • Redefining Functional Status (RFS)
    • 2022 State of Cancer Survivorship Survey
    • 2021 State of Cancer Survivorship Survey
    • 2020 State of Cancer Survivorship Survey
    • Cancer Care Planning and Communications Act (CCPCA)
  • Get Involved
    • What is Advocacy?
    • Cancer Policy and Advocacy Team (CPAT)
    • Survivorship Champions
    • Subscribe to NCCS Updates
    • Elevating Survivorship
    • Survivor Stories
    • Cancerversary
    • State-Based Cancer Advocacy
  • Resources
    • COVID-19 Resources for Cancer Survivors
    • Survivorship Checklist
    • Cancer Survival Toolbox
    • Telehealth
    • Publications
      • Talking With Your Doctor
      • Self Advocacy
      • Employment Rights
      • Remaining Hopeful
    • Cancer Convos Podcast
    • Taking Charge of Your Care
    • Care Planning for Cancer Survivors
    • Tools For Care Providers
    • Order Our Resources
  • News
  • Events
    • Ellen L. Stovall Award
      • 2022 Winners
      • Awardees
      • Sponsors
      • Committees
    • Cancer Policy Roundtable (CPR)
      • Fall 2022 CPR
      • Spring 2022 CPR
      • Fall 2021 CPR
      • Spring 2021 CPR
      • Fall 2020 CPR
      • Spring 2020 CPR
    • Cancer Policy and Advocacy Team (CPAT) Virtual Symposium 2022
    • 2022 State of Survivorship Survey Results
    • Webinars
  • Contact Us
  • Search
  • Menu Menu
  • 0Shopping Cart

Your generous year-end donation will be matched $1 for $1    DONATE

HafftyThumb

Guest Post: Arizona Republic Article Shows Self-referral Abuse Persists

October 30, 2014/in Cancer News, Cancer Policy Blog Access to Care, Health Care Coverage, Payment Reform, Quality Cancer Care NCCS News /by actualize
Haffty

Bruce G. Haffty, MD, is currently professor and chairman of the Department of Radiation Oncology at UMDNJ-Robert Wood Johnson Medical School and associate director at the Cancer Institute of New Jersey.

A recent Arizona Republic article, “Medical ‘self-referral’ practice raises conflict of interest questions”, exposes serious concerns about self-referral abuse in prostate cancer treatment in Phoenix and across the country. It tells a particularly troubling story about an elderly prostate cancer patient with poor vision whose urologist steered him unnecessarily to make long drives to the radiation treatment center the urologist owned.

Self-referral abuse occurs when physicians exploit a loophole in the federal physician self-referral law to refer their Medicare patients for certain health care services they own or in which they have a financial interest. While the law was intended to allow patients to receive certain quick turnaround services – such as basic lab tests and X-rays — concerns emerged that financial incentives were leading some physicians to refer patients for more complex diagnostics and treatments that may not have been necessary or appropriate. Concerns also were raised about unnecessary spending for the Medicare program and out-of-pocket costs for patients.

These anecdotes prompted Congress to ask the Government Accountability Office (GAO) to look into the self-referral loophole. In July 2013 the GAO released a report on physician self-referral for radiation oncology prostate cancer treatments – specifically intensity modulated radiation therapy (IMRT).  The study found that IMRT use among self-referring urologists increased by 456%, while IMRT use among non-self-referring urologists decreased by 5% from 2004-2010. The GAO report prompted a leading urologist to call for closing the self-referral loophole.

In addition, an independent study published in the New England Journal of Medicine in October 2013 came to a similar conclusion — urologists who acquired ownership of IMRT increased their use of the technology substantially more than urologists who did not own such services.  The difference was even more stark when self-referring urologists were compared to the nation’s leading cancer hospitals.

In recent years, numerous published articles and studies have examined self-referral abuse, not only in radiation oncology, but in anatomic pathology, radiology, and physical therapy.  These studies all arrived at the same conclusion – self referral leads to overutilization.

Representative Jackie Speier (D-CA) introduced legislation (H.R. 2914) last year to close the loophole and end these abuses for radiation oncology and other services. The bill curbs the inherent conflict of interest, without limiting access to care for rural patients and while continuing to promote integrated delivery systems designed around quality and value. President Obama also supports closing the loophole for these four services, and the Congressional Budget Office estimates that doing so will save the Medicare program $3.4 billion dollars over 10 years.

Patients should not have to question whether financial incentives are driving their physician’s treatment recommendations.  Unfortunately, the continuous stream of data and patient testimonials indicates that patient choice is being restricted and that some patients are receiving treatments that may not be medically necessary.   This poses a potential risk of harm to patients and increased medical costs.

While physicians generally want to do the right thing, the evidence clearly shows that self-referral creates a conflict of interest that cannot be ignored. Eliminating self-referral exploitation roots out the abuse without reducing benefits or limiting access. I am hopeful that the Arizona Republic article and others encourage Congress to take a closer look at this very important issue to ensure that patients are receiving proper and necessary treatments.

Guest Post by Dr. Bruce Haffty. The views & opinions expressed in any guest post featured on our site are those of the guest author and do not necessarily reflect the opinions & views of the National Coalition for Cancer Survivorship. Read our blog and comment policies here.

Tags: cancer care, Guest Post, Medicare, payment reform
Share this entry
  • Share on Facebook
  • Share on Twitter
  • Share on WhatsApp
  • Share on LinkedIn
https://canceradvocacy.org/wp-content/uploads/2014/10/HafftyThumb.jpg 321 800 actualize https://canceradvocacy.org/wp-content/uploads/2020/06/NCCA-Logo.png actualize2014-10-30 11:00:322020-10-22 10:33:24Guest Post: Arizona Republic Article Shows Self-referral Abuse Persists

Latest News

NCCS Advocate Spotlight: Sharon Rivera Sanchez - Triple Negative Breast Cancer Survivor Finds Passion in Fitness and Advocacy

Sharon Rivera-Sanchez: Triple Negative Breast Cancer Survivor Finds Passion in Fitness and Advocacy

January 12, 2023
As a Triple Negative Breast Cancer survivor, Sharon turned her personal experience into a passion for advocacy and giving back to the community. When she received her diagnosis in May 2015, she remembers being in a state of shock and grief. She said, “You have to allow yourself time to breathe and grieve.”
Read more
https://canceradvocacy.org/wp-content/uploads/Advocate-Spotlight-Sharon-Rivera-Sanchez.jpg 600 1200 NCCS Staff https://canceradvocacy.org/wp-content/uploads/2020/06/NCCA-Logo.png NCCS Staff2023-01-12 15:24:442023-01-12 15:24:44Sharon Rivera-Sanchez: Triple Negative Breast Cancer Survivor Finds Passion in Fitness and Advocacy
Rep. Debbie Wasserman Schultz introduces Comprehensive Cancer Survivorship Act at December 14, 2022 press conference.

NCCS Celebrates Launch of Comprehensive Cancer Survivorship Act

December 14, 2022
Representative Debbie Wasserman Schultz (FL-23), a champion for cancer survivors and a survivor herself, held a press conference today…
Read more
https://canceradvocacy.org/wp-content/uploads/CCSA-Blog-Featured-Image-1200-×-600-px-1.png 600 1200 Kara Kenan https://canceradvocacy.org/wp-content/uploads/2020/06/NCCA-Logo.png Kara Kenan2022-12-14 16:03:462022-12-14 16:03:46NCCS Celebrates Launch of Comprehensive Cancer Survivorship Act
Alique Topalian, PhD, MPH Advocate Spotlight

Alique Topalian: Childhood Cancer and the Frightening Realities of the Survivorship Journey

December 7, 2022
Alique was first diagnosed with Acute Myeloid Leukemia (AML) at the age of four. Her mother, Michele, knew something was wrong because “the light in her eyes was gone”. After being told by doctors that there was nothing wrong, her family was relentless until new blood work uncovered blast cells.
Read more
https://canceradvocacy.org/wp-content/uploads/Alique-Topalian-Advocate-Spotlight.jpg 600 1200 NCCS Staff https://canceradvocacy.org/wp-content/uploads/2020/06/NCCA-Logo.png NCCS Staff2022-12-07 11:46:562022-12-07 11:48:28Alique Topalian: Childhood Cancer and the Frightening Realities of the Survivorship Journey

Take Action

Make An Impact

We are relentless in improving the quality of care and life after a cancer diagnosis. Your support makes all the difference right now.

Make a Gift »

Join CPAT

The NCCS Cancer Policy & Advocacy Team (CPAT) is a program for survivors and caregivers to learn about pressing policy issues that affect quality cancer care in order to be engaged as advocates in public policy around the needs of cancer survivors.

Share Your Story

NCCS represents the millions of Americans who share a common experience – the survivorship experience – living with, through and beyond a cancer diagnosis.

STAY CONNECTED

Together we can improve cancer care for survivors! Sign up to be the first to know about cancer policy issues and ways to take action

  • This field is for validation purposes and should be left unchanged.

  • About
    • Our Mission
    • Our History
    • The 1986 Club
    • Our Team
      • Policy Advisors
    • Employment
    • Partnerships
    • Financial Information
  • Policy
    • Quality Cancer Care
    • Access to Care
    • Health Equity
    • Redefining Functional Status (RFS)
    • 2022 State of Cancer Survivorship Survey
    • 2021 State of Cancer Survivorship Survey
    • 2020 State of Cancer Survivorship Survey
    • Cancer Care Planning and Communications Act (CCPCA)
  • Get Involved
    • What is Advocacy?
    • Cancer Policy and Advocacy Team (CPAT)
    • Survivorship Champions
    • Subscribe to NCCS Updates
    • Elevating Survivorship
    • Survivor Stories
    • Cancerversary
    • State-Based Cancer Advocacy
  • Resources
    • COVID-19 Resources for Cancer Survivors
    • Survivorship Checklist
    • Cancer Survival Toolbox
    • Telehealth
    • Publications
      • Talking With Your Doctor
      • Self Advocacy
      • Employment Rights
      • Remaining Hopeful
    • Cancer Convos Podcast
    • Taking Charge of Your Care
    • Care Planning for Cancer Survivors
    • Tools For Care Providers
    • Order Our Resources
  • News
  • Events
    • Ellen L. Stovall Award
      • 2022 Winners
      • Awardees
      • Sponsors
      • Committees
    • Cancer Policy Roundtable (CPR)
      • Fall 2022 CPR
      • Spring 2022 CPR
      • Fall 2021 CPR
      • Spring 2021 CPR
      • Fall 2020 CPR
      • Spring 2020 CPR
    • Cancer Policy and Advocacy Team (CPAT) Virtual Symposium 2022
    • 2022 State of Survivorship Survey Results
    • Webinars
  • Contact Us

National Coalition for Cancer Survivorship
8455 Colesville Road  |  Suite 930  |  Silver Spring, MD 20910
877-NCCS-YES  |  info@canceradvocacy.org
Privacy Policy  |  Terms and Conditions

Copyright © 1995-2023 by the National Coalition for Cancer Survivorship
National Coalition for Cancer Survivorship, NCCS, Cancer Survival Toolbox, and related Logos are registered in the United States as trademarks of the National Coalition for Cancer Survivorship.

A Tribute to Survivorship and a Happy Cancerversary to Our Friend and Colle... Survivorship and a Happy Cancerversary NCCS Starburst Thumbnail WCOE: Brookings Event Examines Cost and Value, the ACA, and Accounting Practices...
Scroll to top
Download the Survey Report

"*" indicates required fields

Fill out the form below, and we’ll send the survey report, detailed presentation, and infographic to your email.
Name*
I am a...*
Select any/all that apply.
Consent*
By downloading the survey materials, you will receive updates and information from NCCS via email, which you may unsubscribe from at any time. Your information will never be sold to any third parties.
This field is for validation purposes and should be left unchanged.

Get Updates From NCCS

Be the first to hear about cancer policy and survivorship issues! Subscribe and receive the biweekly NCCS Health Care Roundup, invites to webinars and events, and more.

  • This field is for validation purposes and should be left unchanged.

Connect With Us

Twitter     Facebook     Instagram     LinkedIn     YouTube

Harmar Brereton, MD

Founder
Northeast Regional Cancer Institute

 

“Perhaps one of the most impactful collaborations in Dr. Brereton’s extraordinary career remains his early work and long friendship with Ellen Stovall. Through him, and in turn through the thousands of lives he has touched, Ellen’s work continues, and her mission lives on.”

—Karen M. Saunders
President, Northeast Regional Cancer Institute