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PHA Endorses Legislation to Repeal Physician-Led Hospital Ban

October 21, 2022

PHA endorses H.R. 8132, which would repeal the ban on physician-led hospitals.

WASHINGTON – Physician-Led Healthcare for America (PHA) endorsed H.R. 8132, which was introduced by Congresswoman Victoria Spartz (R-Indiana) to remove the ban on physician-led hospitals.

“Concerns related to hospital consolidation have captured the attention of both sides of the political aisle,” PHA President Frederic Liss said. “Americans cannot continue to absorb dramatic healthcare cost increases every year and increased wait times for surgery. This legislative package represents a thoughtful attempt by Congresswoman Spartz to increase quality and lower costs for Americans. In particular, PHA supports the legislation, H.R. 8132, that would remove the ban on physician-led and owned hospitals.”

Click here to view PHA’s endorsement of H.R. 8132.

The bills include:

Flexibility in Hospital Ownership Act – H.R. 8132

H.R. 8132 follows up on existing legislation (H.R. 1330) introduced by Texas Congressman Michael Burgess, MD, and it would remove the Affordable Care Act’s ban on physician-led and owned hospitals. A Senate companion that is co-sponsored by the two Texas Senators was introduced in May.

Competition in State Health Care Markets Act – H.R. 8130

The bill would direct the U.S. Department of Health and Human Services to conduct a study on health care competition and consolidation at the state level.Specifically, the bill would examine:

Licensing requirements for physicians and other clinicians as they relate to initial licensure, ongoing maintenance of licensure, specific training and postgraduate and CME, residency supervisory requirements and board certification.

Vertical and horizontal mergers and acquisitions involving hospitals, ASCs, outpatient practices, health insurance plans, therapy services and telehealth.

State laws that relate to merger approvals and certificates of need.

Alternative health plans, such as short-term limited duration plans and association health plans.

Addressing Anti-Competitive Contracting Clauses Act – H.R. 8135

The bill would require the General Accountability Office (GAO) to evaluate the effects of anti-competitive contracting clauses in contracts between health insurers and healthcare “providers” and to determine actions taken by the Federal Trade Commission and Department of Justice to assess the contracts in relation to federal anti-trust laws.

Consumer Choice of Care Act – H.R. 8134

The bill would eliminate Medicare’s inpatient-only list.

Transparency of Hospital Billing Act – H.R. 8133

The bill would take a different approach to addressing the hospital acquisition of physician practices for the purpose of billing at a higher hospital-based rate by creating a billing identifier for off-campus services and directing the National Association of Insurance Commissioners to create a model act that would allow health plans to reject “abusive” claims. The legislation references Colorado House Bill 18-1282.

The legislation would reverse existing site neutral payment laws and regulations that direct Medicare to pay certain off-campus provider departments to be paid at a “site neutral rate.” Instead of applying a blanket to all hospital-acquired practices, this concept would create a targeted approach for health plans to focus on “abusive” billing practices.

Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act – H.R. 8129

The bill would give the Federal Trade Commission authority over hospital organizations that operate under as a 501(c)3.

Increasing Competition for Medical Residency Act – H.R. 8131

The bill would repeal the anti-trust exemption applicable to graduate medical resident matching programs.

Non-Profit Hospital Tax Exemption Transparency Act – H.R. 9080

The bill would create new community benefit standards for tax-exempt hospital organizations.