Self-Referral Ban Considered by Congress

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By Walter Eisner

In a classic camel’s nose under the tent scenario, the first big health care bill that will likely be voted on by Congress this year, reportedly includes a provision to ban physician self-referrals to hospitals in which they have an ownership interest.

The bill to reauthorize the State Children’s Health Insurance Program (SCHIP) is pitting the American Hospital Association, which supports the House version, against the advocate for physician-owned facilities, Physicians Hospitals of America (PHA). The PHA argues that including the ban would shut down hospitals. The House version includes the ban while the Senate version does not.

The House bill seeks to expand health insurance to cover over 10 million kids over the next 4-1/2 years. That’s an additional 4.1 million new kids over the current authorization. The Senate bill would spend $31.5 billion to cover 3.9 million additional children over the next few years.
The bill, scheduled for a vote this week in the House, is very much like the legislation vetoed by President Bush in 2007.

After the House votes on the measure, the Senate will take up the bill and differences will be ironed out. If the ban is included in the SCHIP program, it will certainly give fodder to those who want to apply the ban to all federally funded health care programs.
We’ll be watching this one closely.

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