On September 17, WHA and members with hospitals in Congressman Jim Sensenbrenner’s district met with the congressman in his office in Brookfield. The topic of discussion was the physician self-referral law, better known as the Stark Law. With the ripe appetite in Washington for regulatory reform, WHA has made Stark Law reform a priority in recent federal advocacy efforts. WHA has followed hearings in the House Ways and Means Committee and also submitted comments in response to a Request for Information from the Centers for Medicare and Medicaid Services (CMS) that closed in August.
The original law was designed to ensure physicians refer patients for services and tests only based on whether they are necessary, by making sure physicians do not receive financial incentives for such referrals. However, since then, numerous regulations have been added to the federal register, making the law complex to comply with. WHA has heard from hospitals and health systems small and large who have expressed concerns over the amount of attorney time and other resources spent on reviewing physician compensation arrangements and other aspects of the Stark Law, time that would be better spent on direct patient care.
Congressman Sensenbrenner noted that he served in Congress with Pete Stark, the former California Congressman who the current law is named after, though he had concerns with the law even then and did not support it. He said he would welcome efforts to reform the law and reduce its regulatory burden on hospitals and recommended WHA and its members work with Congress next session, as it is unlikely to be taken up in the current session.
WHA also urged Sensenbrenner to sign onto a letter WHA is coordinating with Wisconsin’s Congressional Delegation, expressing concerns with CMS’ recent proposal to extend site-neutral payment reductions to off-campus hospital outpatient departments. This CMS proposal is projected to reduce payments by about $30 million to 40 Wisconsin hospitals, including five in Sensenbrenner’s district. WHA members noted the proposal seemed to be in conflict with two separate acts of Congress that had intentionally grandfathered hospitals participating in the existing payment structure.