On the subject of contacting your legislators during the summer

[Guest guest]

On the subject of contacting your legislators, this from the Medical Group Management Association's (MGMA) website.....you may want to address this as well.

A. Stieglitz, MS,PT,ATCChief Operating OfficerIntegrated Rehabilitation Services, LLCPT-PAC Trustee, APTA

introduces self-referral reform bill

At a July 28 press conference, House Ways and Means Health Subcommittee Chairman Bill (R-CA) announced his intention to "remove a very dark cloud" over the medical community – the compensation portion of the Stark self-referral law. Introduction of the legislation, H.R. 2651, the "Physician Self-Referral Amendments of 1999," is a critical first step in MGMA's efforts to remove barriers to medical group practice integration and evolution. Over the past several months, MGMA, in conjunction with the American Medical Group Association (AMGA), has been engaged in a major legislative and grassroots campaign to amend the self-referral law. In a joint press statement, MGMA President and CEO, F. e, M.D., urged Congress to pass the bill, noting, "The confusing nature of the self-referral law has a detrimental impact on the delivery of quality health care. Medical group practices often have difficulty interpreting the ambiguous law, and this is compounded by the fact that final regulations will not be published until at least the middle of the year 2000. Representative ' bill will remedy the chronic ailment medical group practices suffer from under the current law." Despite attempts by Ranking Member Pete Stark (D-CA) to dissuade Democrats from supporting the legislation, Representative Baird (D-WA) has agreed to co-sponsor ' legislation. With your support, Baird will be the first of many Democrats and Republicans to unify in support of repealing the compensation portion of the self-referral law. BillMGMA worked with Representative to craft legislative language that would amend provisions of the self-referral law that detrimentally impact group practices. What characterized today as "a very modest piece of legislation," would in fact address the bulk of the concerns facing medical group practices. Of most importance to MGMA, the bill would:

remove the "compensation arrangement" provision of the law, which interferes with business activities that are essential to the successful operation of multifaceted, integrated health care organizations; clarify the definition of "group practice" contained in the law, which would enable a clear and uniform application to the broad spectrum of physician practices that exist today; and delay the effective date of "Stark II" until the Secretary of Health and Human Services (HHS) issues final regulations.

Stark introduces self-referral billRepresentative Pete Stark (D-CA) responded to the initiative by introducing his own self-referral proposal. On July 29, he introduced "The Medicare Physician Self-Referral Improvement Act of 1999." Representative Stark's bill would replace existing compensation exceptions with a single fair market value test. Under the fair market value test, an agreement must be in writing for a definite period of time and not be dependent on the value of the referral. In addition, the bill addresses the following issues: physician supervision, managed care exemption, reporting requirements, eyeglasses and lenses, advisory opinions and durable medical equipment. While the bill makes some changes to the existing self-referral law, MGMA believes only the bill introduced by Representative , H.R. 2651, adequately addresses group practice concerns. The fair market value test would not address the most significant concerns of MGMA's membership. In addition, it would be virtually impossible to determine "fair market value" as it relates to direct or indirect compensation arrangements. Co-sponsors neededAlthough supported by a majority of the health care community, the bill is certain to face opposition. We must maintain pressure on Congress to act now in support of the "Physician Self-Referral Amendments of 1999. MGMA members can play a crucial role in securing co-sponsors. MGMA needs you to write to your elected officials. Please write or email your Representative's office before Aug. 6, 1999, and request that he or she co-sponsor the bill to implement improvements to the self-referral law. Click here to find a sample letter providing an example of what you might write. As always, please incorporate personal examples from your own practice into your letter addressing the problems highlighted in the sample letter. Personal examples are the most effective means of driving home a message to your elected officials!

For more information, please call the MGMA Government Affairs Department at , or use our online comment form.

on a related note...

Background on Stark Laws and proposed regulations Other writing tips Organize on MGMA's discussion groups Locate your elected officials. Read an article describing MGMA's position