Representatives Jackie Speier (D-CA), Ways and Means Health Subcommittee Ranking Member Jim McDermott (D-WA) and Dina Titus (D-NV), recently introduced H.R. 2914, the Promoting Integrity in Medicare Act of 2013 (PIMA), in the House of Representatives. PIMA would largely prohibit self-referral for advanced medical imaging, radiation therapy and certain other medical services not typically performed at the time of the patient’s initial office visit.

Current federal law — also known as the Stark Law — bars physicians from referring Medicare patients for certain health care services in which they have a financial interest, but includes an "in-office ancillary services" exception. PIMA would greatly narrow this exception.

Government Accountability Office reports have examined self-referral of medical imaging and radiation therapy services. These reports have found significant and inappropriate increases in referrals when physicians are allowed to self-refer. The practice of self-referral drives up utilization of these services and drains Medicare of hundreds of millions of dollars every year.

Overall, medical imaging use and associated costs are down significantly since 2006. Medicare spends the same amount on imaging scans now as in 2003. Only self-referred imaging grew significantly since the middle of the last decade.

The PIMA bill is supported by the Alliance for Integrity in Medicare (AIM), a broad coalition of medical societies committed to ending the practice of inappropriate physician self-referral and focused on improving patient care and preserving valuable Medicare resources. The American College of Radiology is a founding member of AIM.