Issue Background

Preserving Medicare Integrity and Keeping Medicare Affordable

As taxpayers, Medicare beneficiaries, the relatives of such beneficiaries, or future Medicare beneficiaries, we should all be concerned about the future of our healthcare programs and stop practices that result in unnecessary utilization and costs.  

Physician financial incentives should not dictate the quality, type or quantity of care available to medicare and medicaid patients – preserve patient choice, patient safety and the medicare and medicaid programs with your support of the Promoting Integrity in Medicare Act of 2013!

The Alliance for Integrity in Medicare  (AIM) supports the Promoting Integrity in Medicare Act of 2013 (H.R. 2914). This legislation would narrow the loophole in the existing physician self-referral law (otherwise known as the Stark Law) which allows physicians to refer their Medicare patients for certain ancillary healthcare services owned by and contained within the physician practice.

Numerous studies from the GAO (Government Accountability Office) and leading health services and policy researchers consistently arrive at the same conclusion – the financial incentives inherent in owning these ancillary health services leads to more utilization of these services – more scans, more biopsies, more radiation therapy.    As a patient trusting your physician’s advice, would you want your physician’s recommendations influenced by whether they were going to profit from these recommendations?    What if some of these recommendations carried with them additional risks, such as the risk of infection associated with a prostate biopsy? 

MedPAC’s Report to the Congress: Medicare and the Health Care Delivery System

MedPAC’s Report to the Congress: Aligning Incentives in Medicare


Utilization Studies on Physician Self Referred Services

Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions

Action Needed to Address Higher Use of Anatomic Pathology Services by Providers Who Self-Refer

Higher Use of Costly Prostate Cancer Treatment by Providers Who Self-Refer Warrants Scrutiny