FOR IMMEDIATE RELEASE, Contact: (202) 225-3943
May 4, 1999
No. HL-5
Congressman Bill Thomas (R-CA), Chairman, Subcommittee on Health of the Committee on Ways and Means, today announced that the Subcommittee will hold a hearing on the Health Care Financing Administration's (HCFA) implementation of the Medicare self-referral laws and its impact on the health care marketplace. The hearing will take place on Thursday, May 13, 1999, in the main committee hearing room, 1100 Longworth House Office Building, beginning at 1:00 p.m.
In view of the limited time available to hear witnesses, oral testimony at this hearing will be from invited witnesses only. However, any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the Committee and for inclusion in the printed record of the hearing.
BACKGROUND:
"Self-referral" is the term used to describe the situation where a physician or other provider refers a patient to a medical facility in which the physician has a financial interest. In the Omnibus Budget Reconciliation Act of 1989 (OBRA 89, P.L. 101-508), the Congress passed what became known as "Stark I" after the main sponsor, Rep. Pete Stark (D-CA). Under that law, in general, if a physician has a financial relationship with a clinical laboratory, that physician cannot make a referral to the laboratory for the furnishing of services for which Medicare pays. The Omnibus Budget Reconciliation Act of 1993 (OBRA 93, P.L. 103-66) extended the law to apply to referrals for 10 "designated health services," in addition to clinical laboratory services. This law became known as "Stark II." Five years after passage of Stark II, on January 9, 1998, HCFA issued a proposed rule to implement it. Today, after an additional 17 months, HCFA seems no closer to issuing a final rule on the Federal statute.
The guiding principle for the self-referral laws was to prevent physicians from inappropriately referring patients based on the potential for financial gain. Yet, the health care delivery system has changed profoundly since passage of the first self-referral laws. Since 1989, the health care system has rapidly moved away from the traditional fee-for-service way of delivering medical care. Today, the health care system has moved towards a more coordinated, integrated approach.
The Balanced Budget Act of 1995 (BBA95) included several amendments to the self-referral laws. The two major changes were the repeal of the prohibitions based on compensation arrangements and the revision of the list of facilities subject to the ban. BBA95 was vetoed by President Clinton on December 6, 1995.
In announcing the hearing, Chairman Thomas stated: "Physicians and hospitals are subject to a bewildering array of overlapping State and Federal statutes. Many of the steps physicians and hospitals take to integrate their practices are subject to a multitude of laws, including self-referral law, anti-kickback law, Federal tax law regulating the conduct of tax-exempt organizations, State referral bans, corporate practice of medicine prohibition and the Federal False Claims Act. The fact that it has taken the HCFA more than six years to put out a final rule is further evidence that these laws are in need of an overhaul."
FOCUS OF THE HEARING:
The hearing will focus on implementation of existing self-referral statutes and on areas for reform. The Subcommittee will also consider proposals put forward by the Administration and Members of Congress.
DETAILS FOR SUBMISSION OF WRITTEN COMMENTS:
Any person or organization wishing to submit a written statement for the printed record of the hearing should submit six (6) single-spaced copies of their statement, along with an IBM compatible 3.5-inch diskette in WordPerfect 5.1 format, with their name, address, and hearing date noted on a label, by the close of business, Thursday, May 27, 1999, to A.L. Singleton, Chief of Staff, Committee on Ways and Means, U.S. House of Representatives, 1102 Longworth House Office Building, Washington, D.C. 20515. If those filing written statements wish to have their statements distributed to the press and interested public at the hearing, they may deliver 200 additional copies for this purpose to the Subcommittee on Health office, room 1136 Longworth House Office Building, by close of business the day before the hearing.
FORMATTING REQUIREMENTS:
Each statement presented for printing to the Committee by a witness, any written statement or exhibit submitted for the printed record or any written comments in response to a request for written comments must conform to the guidelines listed below. Any statement or exhibit not in compliance with these guidelines will not be printed, but will be maintained in the Committee files for review and use by the Committee.
1. All statements and any accompanying exhibits for printing must be submitted on an IBM compatible 3.5-inch diskette in WordPerfect 5.1 format, typed in single space and may not exceed a total of 10 pages including attachments. Witnesses are advised that the Committee will rely on electronic submissions for printing the official hearing record.
2. Copies of whole documents submitted as exhibit material will not be accepted for printing. Instead, exhibit material should be referenced and quoted or paraphrased. All exhibit material not meeting these specifications will be maintained in the Committee files for review and use by the Committee.
3. A witness appearing at a public hearing, or submitting a statement for the record of a public hearing, or submitting written comments in response to a published request for comments by the Committee, must include on his statement or submission a list of all clients, persons, or organizations on whose behalf the witness appears.
4. A supplemental sheet must accompany each statement listing the name, company, address, telephone and fax numbers where the witness or the designated representative may be reached. This supplemental sheet will not be included in the printed record.
The above restrictions and limitations apply only to material being submitted for printing. Statements and exhibits or supplementary material submitted solely for distribution to the Members, the press and the public during the course of a public hearing may be submitted in other forms.
The
Committee seeks to make its facilities accessible to persons with
disabilities. If you are in need of special accommodations, please
call 202-225-1721 or 202-226-3411 TTD/TTY in advance of the event
(four business days notice is requested). Questions with regard to
special accommodation needs in general (including availability of
Committee materials in alternative formats) may be directed to the
Committee as noted above.