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John W. Mitchell, Senior Correspondent | January 17, 2017
He explained that a radiologist is at the receiving end of a request from a referring physician to perform and interpret an imaging examination. In many of those encounters, he said, a radiologist may decide to substitute one imaging study for another. For example, ordering an ultrasound to get the same answer at lower cost, with no radiation exposure to the patient. Or the radiologist might decide not to perform a study at all. An example of this would be to for the radiologist to review a CD of a CT scan that was just done a few days ago at another hospital.
There are also federal regulations governing such payments. Duszak said in private outpatient settings and independent testing facilities Medicare generally precludes diagnostic radiologists from ordering substitute imaging examinations.
"So there are some regulatory requirements in place that make it illegal ... to drive imaging, even if the industry incentives were strong enough to make them want to," he said.
He also stressed that the study is not meant to be critical of any non-research payments to radiologists.
"We're really not in a position to call out individual payments as atypical, since we did not audit individual payments, or how much was too much for an individual payment," said Duszak. "That’s potentially an opportunity for future work, but wasn’t our focus."
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