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SF 1105

A resolution to restore patient protection laws; urging certain federal agencies to repeal waivers of antitrust, anti-free-splitting, and anti-self-referral laws and urging an amendment to the federal law to require that clinics and hospitals have freedom to contract or not contract for payment contingent on the volume of orders for care

2025-2026 Regular Session Introduced by Glenn Gruenhagen

Minnesota urges federal agencies to eliminate healthcare payment waivers allowing volume-contingent contracts between providers, restricting referral-based compensation arrangements.

Referred to Health and Human Services
#commerceandcommercedepartment #government-federal #healthandhealthdepartment #resolutions
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Bill Summary · SF 1105

Legislative bill overview

SF 1105 is a resolution urging federal agencies to rescind existing waivers that exempt certain healthcare providers from antitrust and anti-self-referral laws, and to amend federal law to give clinics and hospitals the right to refuse contracts based on referral volume. The bill targets payment arrangements that tie compensation to the quantity of patient referrals between affiliated healthcare entities.

Why is this important

These "gain-sharing" arrangements and referral-based contracts have been permitted under federal waivers since the 1990s, allowing hospitals and physicians to coordinate on cost-reduction while potentially influencing treatment decisions. Restricting these arrangements could affect how healthcare networks negotiate prices and coordinate care, with implications for both healthcare costs and quality of care.

Potential points of contention

  • Economic impact uncertainty: Restrictions on volume-based contracts could reduce provider negotiating power against insurance companies and drug manufacturers, potentially raising costs for some services while limiting efficiency gains.
  • Care coordination vs. self-dealing: Supporters argue these protections prevent inappropriate referrals for profit; opponents contend legitimate efficiency partnerships would be eliminated alongside problematic arrangements.
  • Federal vs. state authority: The resolution asks federal agencies to act rather than implementing state-level policy, raising questions about Minnesota's leverage and whether this duplicates existing enforcement efforts by the Department of Justice and HHS Office of Inspector General.

Compiled from official sources — confirm details with the bill’s official record.

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