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CHAMP self-referral ban may hit physician owners

Ambulatory Surgery Reimbursement Update, August 7, 2007

Under the proposed Children's Health and Medicare Protection Act (CHAMP), which Congress released July 25, physicians would be barred from referring patients to hospitals in which the physicians had an interest, according to section 651 of the bill.

However, the Act would permit physicians to refer patients to hospitals under a grandfather clause, which allows the practice if the hospital was Medicare-registered prior to July 24, 2007.

The clause includes hospitals if they meet the following requirements:

• Physician owners do not own more than 40% of the total value of the investment interests in the hospital
• Physician owners' investment interest does not exceed 2% per individual
• Any ownership or investment interests that the hospital offers to a physician owner are not offered on more compelling terms than the terms offered to a person who is not a physician owner

Also, the Secretary of Health and Human Services will conduct audits no less than 18 months after Congress enacts the bill, to determine if hospitals are violating the requirements.

To view full text of the CHAMP bill, click here.

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