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Physicians' conflicts in patient referrals.


 Representative Stark, author of the Ethics in Patient Referrals Act (HR 939), argues for the need for federal oversight of the physician practice of referring patients to health facilities in which the physician has a financial interest. He takes issue with some of the conclusions reached by E. Haavi Morreim in her article in the same issue of JAMA on the problem of physician self referral. She proposes physician disclosure of interests, utilization review, quality assurance, and a judicially fashioned, common law remedy to discourage referral abuses. Stark argues that these approaches cannot effectively address the problem, and that the federal government, as an informed purchaser of health services through Medicare, should not pay for self referral.
