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Oregon’s Legislature is considering a bill that would restrict—but not prohibit—hospital-based physicians from referring patients to another hospital-owned entity for MRI, CT scans, and radiation therapy. The bill also would require such physicians to inform patients about the hospital’s financial interest in any such referral.

According to The Lund Report, a news Web site devoted to health care in Oregon, the measure was designed to help independent radiologists and physical therapists—and their patients. It passed the Senate in April and got a hearing before a House committee last week.

Radiologist Christopher Altenhofen, MD, medical director at Epic Imaging in Portland, said that when one hospital referred a patient for  PET scan, it gave her only an in-house option that would have required a nine-day wait. Instead, the patient checked with his clinic and got the scan the next day.

Dianna Godwin, an attorney for Oregon Physical Therapists in Independent Practice, said some hospital systems insist that patients use in-house therapists, even if an independent therapist could begin treatment more quickly. When patients have asked to use an outside therapist, some physicians have rescinded the referral, Godwin said.

One independent physical therapist who withheld his name for fear of retaliation from hospital systems said some hospitals try to keep patients with high-paying insurance and dump patients with lower-paying Medicare or Oregon Health Plan coverage.

The bill, Senate Bill 683, faces an uncertain legislative future. It has already been watered down; originally it banned all self-referrals. Senator Laurie Monnes Anderson, D-Gresham, a retired public health nurse, killed two similar bills because, she said, federal laws already provide adequate self-referral regulation. Senator Elizabeth Steiner Hayward, MD, D-Portland, voted against SB 683, saying:

I’m not sure it does all it’s intended to do.

Asked by The Lund Report to elaborate, she declined. Dr. Steiner Hayward is a family physician at Oregon Health & Science University, which operates a large hospital system. OHSU and the Oregon Association of Hospitals and Health Systems do not currently support the bill  but are trying to get it amended.

Related seminar: UW Radiology Review Course “Not Just for Residents” (pre-order by May 31—the end of next week—and save $200)


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