Stop Ordering Unnecessary Tests for Medicare Patients

Target: Marilyn Tavenner, Centers for Medicare and Medicaid Services Administrator

Goal: Stop allowing doctors to refer Medicare patients to their own testing facilities

A recent study found that physicians who own image testing equipment, such as MRIs and CT Scans, tend to refer their Medicare patients for those tests at a much higher rate than other doctors. This has resulted in the government spending millions of dollars each year on unnecessary tests for the personal financial gain of those medical professionals. In addition to wasting taxpayer money, this practice increases patients’ exposure to harmful radiation, putting their health at risk. Doctors must be prevented from referring patients to their own image testing facilities so that these tests will only be given when necessary.

The study found a drastic difference between the number of imaging tests ordered by doctors who were referring patients to their own facilities and those who were not. They also found a dramatic increase in the number of tests recommended by doctors after acquiring the testing equipment, while there was a decrease in tests by those who were still referring patients to outside facilities. The study found that in just one year, there were a total of 400,000 unnecessary imaging tests in the country, costing Medicare over $100 million.

The government agency that conducted the study gave the Department of Health and Human Services (HHS) recommendations for reducing these unnecessary tests, and HHS agreed to monitor and investigate medical professionals to ensure that the tests are being offered appropriately. Although there have been many instances of Medicare fraud, this type of fraud is difficult to detect, and it is unclear how HHS plans on ensuring that the tests are only given when appropriate while still allowing doctors to refer patients to their own testing facilities.

Doctors need to be trusted to act in patients’ best interests, instead of focusing on their own financial gain at the expense of the Medicare program and the health of their patients. It seems that there are enough untrustworthy physicians who are willing to make medical decisions that could harm their patients that it would not be enough to just monitor these self-referrals; the only way to stop this abuse of the system is to prohibit self-referrals completely.


Dear Marilyn Tavenner,

It was recently discovered that doctors who refer Medicare patients to their own image testing facilities refer a significantly higher percentage of patients than those who refer patients to outside facilities, indicating that doctors who self-refer their Medicare patients have been ordering these tests unnecessarily. This abuse of Medicare funding is costing patients and taxpayers a substantial amount of money, and could even be endangering the health of the patients who are unnecessarily exposed to radiation from the tests.

Although it is commendable that your agency has agreed to start monitoring these self-referring medical professionals to ensure that the tests are being used appropriately, it is unlikely that this will result in a dramatic decrease in unnecessary testing. The only way to prevent doctors from wasting taxpayer money and putting Medicare patients in danger is to stop allowing doctors to refer patients to their own testing facilities.


[Your Name Here]

Photo credit: Muffet via Flickr

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One Comment

  1. Many hospitals are looking to increase their turn over by ordering these unnecessary tests. Government should treat it as one type of fraud.

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