“A bill to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals.”
No CRS summary available for this bill.
This section revises exceptions to the physician self-referral prohibition (Stark Law, 42 U.S.C. 1395nn) applicable to certain physician-owned hospitals. **(a) Covered rural hospital exception.** It defines a "covered rural hospital" in new subsection (h)(8) as a hospital located in a rural area (per 42 U.S.C. 1886(d)(2)(D)) that, upon Medicare enrollment, met the primary distance or volume criteria for sole community hospital designation (per SSA section 1820(c)(2)(B)(i)(I)), without requiring other such criteria. It excludes covered rural hospitals from the limitations otherwise applicable to hospitals under (d)(2)(C) and (d)(3)(D). (Thus, physicians with ownership or investment interests in such hospitals may refer Medicare patients for designated health services furnished there.) **(b) Expansion of physician-owned hospitals.** It amends subsection (i)(1)(B) to reference new paragraph (7) and adds (i)(7) to sunset, effective on enactment, the expansion prohibition previously applicable to grandfathered physician-owned hospitals (i.e., those with physician ownership exceeding specified thresholds as of December 31, 2010). (Thus, such hospitals may expand bed capacity, facility space, or physician ownership without prior percentage caps or exceptional reporting requirements.)