tci Medicare Compliance & Reimbursement - 2005 Issue 43

HOSPITALS: Self-Referrals To Specialty Hospitals Under Scrutiny

Legislators agree with community hospitals; self-referral abuse is wrecking the system.A new study backs community hospitals' objections to controversial patient referrals to physician-owned specialty hospitals. In a recent article published in Health Affairs, the  authors support community hospitals' complaints that the growth in the number of limited-service specialty hospitals in recent years has diverted profitable cases away from their operating rooms and limited their ability to absorb the costs of uninsured or money-losing patients.Arizona cardiologists who are part-owners of cardiac specialty hospitals were more likely than physicians with no ownership stake to treat low-acuity, high-profit cases in...

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