The American Hospital Association (AHA) and Federation of American Hospitals (FAH) released a statement last week to urge Congress to oppose any legislation that would repeal current law limiting self-referral to physician-owned hospitals.
Congress enacted legislation in 2010 that prohibits physician-owned hospitals that opened after Dec. 31, 2010, from billing Medicare or Medicaid. However, it allowed existing physician-owned hospitals in operation at the time of enactment to continue to bill these government payers.
Numerous efforts have been made since 2010 to repeal the ban, but the AHA/FAH release pointed to data in a 2017 study that found physician-owned hospitals:
- Cherry-pick patients by avoiding Medicaid and uninsured patients
- Treat fewer medically complex patients
- Enjoy margins nearly three times those of non-physician owned hospitals
- Provide few emergency services – an important community benefit
- Are penalized for unnecessary readmissions at 10 times the rate of non-physician owned hospitals