Hospital lobbies ask Congress to keep restrictions on physician-owned facilities

In a strongly worded letter, hospital leaders asked members of the House Ways and Means Committee to shoot down pending legislation that would loosen restrictions on physician-owned facilities.

The bill, HR 2513, the Promoting Access, Competition, and Equity Act of 2015, would erode some of the current barriers on physicians owning all or part of hospitals over the next four years. It would temporarily relax ownership restrictions on hospitals that have fairly high Medicare quality ratings and a high level of participation in the Medicaid program.

Physician-owned hospitals encountered severe restrictions under the Affordable Care Act, with new construction or expansion of existing facilities barred as a condition of participating in the Medicare program. Some facilities dropped out of Medicare as a result. 

However, data have suggested over the years that when physicians are able to self-refer cases to facilities in which they have a stake, volume tends to go up dramatically.

"The data is clear. Self-referral to physician-owned hospitals leads to cherry-picking of higher margin and healthier patients, as well as higher utilization of healthcare services that leads to higher costs for taxpayers and employers," said the letter, which was penned by the American Hospital Association, the Association of American Medical Colleges and the Federation of American Hospitals, among others.

If passed into law, the measure "would result in additional gaming of the Medicare program, jeopardize patient access to emergency care, potentially harm sicker and lower-income patients and damage the safety-net provided by full-service hospitals," the letter asserted. "By steering their most profitable cases to facilities they own, physician-owners inflate healthcare costs and drain essential resources from community hospitals." 

To learn more:
​- check out the letter (.pdf)