Reprinted with permission from DCReport.
The Trump administration is trying toÂ weakenÂ a landmark set of laws that prevents doctors from jacking up healthcare costs by ordering unnecessary tests and other medical care at labs and hospitals in which they have financial interests.
The Health and Human Services Department has asked for feedback on theÂ Stark Law,Â a first step toward rolling back the law, or asÂ HHS Secretary Alex Azar put it,Â âtaking regulatory action to reform these rules.âÂ Trump claims he wants to reduce healthcare costs with measures such as repealing Medicaid expansion and reducing prescription drug costs, but the proposed overhaul of the Stark law seems to contradict that.
Almost 400 organizations and peopleÂ commented,Â mostly doctors and healthcare organizations in favor of watering down the protections. The public comment period on the proposal has closed.
âThe Stark Law isÂ no longer necessaryÂ to ensure that providers do not engage in practices that lead to overutilization of health care services and harm to patients and government programs,â wroteÂ Philip Wheeler,Â senior vice president and general counsel atÂ Mercy Health.
In 2017,Â Mercy paid $34 millionÂ to settle claims that its hospital and clinic in Springfield, Mo., violated the Stark Law by submitting false claims to Medicare for cancer treatment.
MercyÂ allegedly paid doctors based in part on its referrals to a Mercy cancer center, and doctors treated patients toÂ maximize reimbursements from Medicare and MedicaidÂ despite patientsâ treatment violating national cancer treatment guidelines.
Some patients were hospitalized because of the excess treatment, according to a lawsuit. A patient with borderline intellectual functioning was given too much chemotherapy and radiation. A doctor who complained about the problems to Mercy authorities wasÂ demoted and then fired.
Cases such as this were why Congress passed the first Stark Law in 1989, named after former U.S. Rep.Â Pete StarkÂ (D-Calif.) who sponsored the bill. A 1989 report from the Office of Inspector General found patients of doctors who owned or invested in clinical labs received 45% more lab services than Medicare patients in general, costing Medicare an estimated $28 million in 1987.
âThe integrity of our nationâs physicians is being threatenedÂ by seductive deals promoted by fast-buck artists,â Stark said in 1989.
The first Stark law prohibited referring Medicare patients to clinical labs by doctors who have financial interests in those labs or whose relatives have financial interests in the labs.Â Health services covered by the Stark lawÂ now also include physical therapy, home health services, medical equipment and supplies and other services.
TheÂ Coalition Against Insurance FraudÂ urged federal regulators not to weaken the law because ofÂ âthe past history of rampant fraud and abuses.â