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OIG report on MRIs

This article was originally published in The Gray Sheet

Executive Summary

According to a Sept. 25 1report from the HHS Office of Inspector General, magnetic resonance imaging (MRI) services are ordered and billed differently when the doctors ordering the services have a connection with the MRI providers through a medical practice or business relationship. OIG analyzed a random sample of 2005 Medicare Part B claims data (547 billers and 599 claims) and data projections. While the study was not designed to analyze MRI appropriateness or medical necessity, it found that one-quarter of MRI services paid under the physician fee schedule in 2005 were "connected services," meaning the physician had some link to the imaging provider, and connected services were furnished and billed "significantly" differently. CMS agreed with the findings and outlined its recent steps to address imaging issues (2"The Gray Sheet" Sept. 15, 2008, p. 20)
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