Congress quietly restores hospital kickback loophole buried in ACA
H.R. 4002 — Patient Access to Higher Quality Health Care Act of 2025 · Filed by Beth Van Duyne (R-TX) · 12 cosponsors · Introduced Jun 12, 2025 · Referred to committee
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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.
The full analysis lists 4 implications of this text.
Who stands to gain
hospitals with physician ownership stakes; physician-owned specialty hospitals; physician-owned imaging and diagnostic centers