Bill Text: HI HCR65 | 2012 | Regular Session | Introduced

Hawaii House Concurrent Resolution 65 (Prior Session Legislation)

Introduced

Bill Title: Stark Law; Physician Self-Referral Prohibition

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2012-03-01 - (H) Referred to HLT, CPC/JUD, referral sheet 38 [HCR65 Detail]

Download: Hawaii-2012-HCR65-Introduced.html

HOUSE OF REPRESENTATIVES	H.C.R. NO.	65
TWENTY-SIXTH LEGISLATURE, 2012
STATE OF HAWAII

HOUSE CONCURRENT

RESOLUTION

URGING THE ENFORCEMENT of AND SUPPORT for THE INTENT OF THE FEDERAL STARK LAW.

WHEREAS, the Stark Law, passed by the United States Congress in 1989 as a provision of the Omnibus Budget Reconciliation Act of 1989, bars physician self-referrals for clinical laboratory services under the Medicare program; and

WHEREAS, the Stark Law was enacted as a means to reduce health care costs by barring physician self-referral, the practice of a physician referring a patient to a medical facility in which the physician has a financial interest, including ownership, investment, or a structured compensation arrangement; and

WHEREAS, subsequently amended by:

(1) The Omnibus Budget Reconciliation Act of 1993, which expanded the restriction to a range of additional health services and applied the restriction to both Medicare and Medicaid; and

(2) Section 1877 of the Social Security Act of 1994, which made technical corrections to the 1993 law,

the Stark Law comprises three separate provisions that govern physician self-referral for Medicare and Medicaid patients; and

WHEREAS, the Stark Law:

(1) Prohibits a physician, subject to certain exceptions, from making referrals for certain designated health services payable by Medicare to an entity with which the physician or an immediate family member has a financial relationship;

(2) Prohibits a subject entity from presenting or causing to be presented claims to Medicare, or billing another individual, entity, or third party payer, for those improperly referred services; and

(3) Establishes a number of specific exceptions and grants the Secretary of the United States Department of Health and Human Services the authority to create by rule exceptions for financial relationships that do not pose a risk for program or patient abuse; and

WHEREAS, the Patient Protection and Affordable Care Act, which was signed into law on March 23, 2010, amends the Stark Law in several areas by:

(1) Adding a new requirement to the in-office ancillary services exception for referrals of certain diagnostic imaging services;

(2) Substantially limiting the scope of the whole-hospital exception permitting referrals to hospitals with which the referring physician has a financial relationship; and

(3) Requiring the United States Department of Health and Human Services, together with the Office of the Inspector General of the United States Department of Health and Human Services, to establish a protocol for health care providers to self-disclose actual or potential violations of the Stark Law; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-sixth Legislature of the State of Hawaii, Regular Session of 2012, the Senate concurring, that the United States Office of the Attorney General; United States Department of Health and Human Services; United States Federal Trade Commission; United States Securities and Exchange Commission; United States Internal Revenue Service; State of Hawaii Office of the Attorney General; State of Hawaii Department of Health; and State of Hawaii Department of Human Services, are urged to enforce the Stark Law to the full extent of their statutory and regulatory authority to do so; and

BE IT FURTHER RESOLVED that AlohaCare; Hawaii Management Alliance Association; Hawaii Medical Service Association; Humana Insurance Company; Kaiser Foundation Health Plan, Inc.; Summerlin Life & Health Insurance Co.; United Health Alliance; United Healthcare Insurance Company; Wellcare Health Insurance of Arizona, Inc.; and other health insurers and managed care providers who serve the people of Hawaii are urged to develop internal policies that facilitate enforcement and support the intent of the federal Stark Law as well as encourage compliance with the reporting requirements under 42 Code of Federal Regulations 411.361, relating to financial relationships; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the United States Attorney General; United States Secretary of Health and Human Services; Chairperson of the Federal Trade Commission; Chairperson of the Securities and Exchange Commission; Commissioner of the Internal Revenue Service; State Attorney General; State Director of Health; State Director of Human Services; Board President of AlohaCare; President and Chief Executive Officer of the Hawaii Management Alliance Association; President and Chief Executive Officer of the Hawaii Medical Service Association; Chairperson and Chief Executive Officer of Humana Insurance Company; President of Kaiser Foundation Health Plan, Inc.; President and Chief Executive Officer of Summerlin Life & Health Insurance Co.; President of United Health Alliance; President and Chief Executive Officer of United Healthcare Insurance Company; and Chief Executive Officer of Wellcare Health Insurance of Arizona Inc.