Congress quietly restores hospital kickback loophole buried in ACA

What it does

This bill repeals three sections of the Affordable Care Act and the Health Care and Education Reconciliation Act that had restricted hospitals' ability to refer patients to physician-owned facilities. By repealing these restrictions, the bill restores the pre-ACA rule that allowed hospitals to make such referrals under Medicare, potentially increasing financial relationships between hospitals and their physician owners.

Why we flagged it

The bill's operative mechanism is the repeal of ACA safeguards designed to prevent hospitals from steering referrals to physician-owned entities for financial rather than medical reasons. It is functionally a deregulation of physician-hospital financial relationships, framed as a patient-access measure.

What the text implies

• Restores financial incentives for hospitals to refer patients to physician-owned specialty hospitals, imaging centers, and other facilities in which the referring physicians have ownership stakes, potentially increasing costs and fragmentation of care.
• Removes transparency requirements and conflict-of-interest disclosures that the ACA had imposed, making it harder for patients and payers to identify when referrals are driven by physician financial interest rather than clinical need.
• May increase Medicare spending if hospitals preferentially refer to higher-cost physician-owned facilities rather than lower-cost alternatives, shifting costs to beneficiaries and the program.
• Restores the pre-2010 regulatory environment in which physician-owned hospitals and facilities proliferated, often in affluent areas and for profitable procedures, potentially widening geographic and socioeconomic disparities in care access.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

The bill removes conflict-of-interest protections that the ACA imposed to prevent hospitals from steering patients to physician-owned facilities for financial gain rather than medical necessity. Patients lose transparency and protection against referral bias, while hospitals and physician-owners gain financial flexibility. The removal of these safeguards increases the risk that referral decisions will be driven by financial incentives rather than patient welfare.

Who stands to gain

• hospitals with physician ownership stakes
• physician-owned specialty hospitals
• physician-owned imaging and diagnostic centers
• physicians with ownership interests in referral-receiving entities

Named in the bill

Centers for Medicare & Medicaid Services (CMS), Patient Protection and Affordable Care Act (ACA), Health Care and Education Reconciliation Act of 2010, Medicare, physician-owned hospitals, specialty hospitals

Where it stands

12 cosponsors: 11 Republicans, 1 Democrats.

• Jun 12, 2025 — Introduced · Congress.gov: “Introduced in House”
• Jun 12, 2025 — Referred to House Committee on Ways and Means and House Committee on Energy and Commerce · Congress.gov: “Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a…”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

10 lobbying clients named this bill on 13 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $13,109,331 in lobbying spend. A filing names 20 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 91% of bills with at least one filing.

Beth Van Duyne, the sponsor, reported $1,221,522 in PAC receipts in the 2026 cycle.

• American Medical Association — $5,643,000 on 2 filings
• American Hospital Association — $4,470,000 on 1 filing
• American Academy of Dermatology Association — $1,030,000 on 2 filings
• American College of Cardiology — $680,000 on 1 filing
• Americans for Prosperity — $660,000 on 1 filing

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.