Dr. DiGiorgio Goes to Washington: Site Neutrality, Stark Law Physician-Owned Hospitals & More

Dr. DiGiorgio Goes to Washington: Site Neutrality, Stark Law Physician-Owned Hospitals & More

Author: The Doctor's Lounge March 31, 2026 Duration: 56:55

Episode Summary

Dr. DiGiorgio returns from testifying before the House Energy and Commerce Subcommittee on Health, the third in a series of hearings on healthcare costs covering the provider landscape. The two break down the major policy levers discussed in his testimony — site-neutral payment, Stark Law reform, physician-owned hospitals, and Certificate of Need laws — and why so many obviously good solutions remain politically untouchable. They also dig into the rural access gap, the failure of the NP independence experiment to solve it, Medicare Advantage risk adjustment, and the new HHS healthcare advisory committee. As always, the diagnosis is clear; the politics are the hard part.


Chapter Markers

0:00 – Welcome back & Dr. DiGiorgio's Congressional testimony

3:16 – Site-neutral payment: why everyone knows it's right and no one acts

6:26 – You can't do site neutrality without also enabling competition

8:20 – How MedPAC's methodology actually works

11:50 – Stark Law explained — and why it creates a double standard

14:32 – Hospice fraud, Armenian gangs, and Nick Shirley

20:30 – The original sin: third-party payment and utilization control

23:52 – The case for allowing physician referral networks

25:15 – Hospitals' self-referral hypocrisy and the Federation of American Hospitals tweet

28:52 – How Section 6001 of the ACA banned physician-owned hospitals

30:13 – The new HHS healthcare advisory committee — will it matter?

37:44 – The rural access gap: how big is the problem really?

42:52 – Why NP independence didn't solve rural shortages

47:58 – International medical graduates and the rural fiction

50:06 – Let prices rise: the market solution to rural primary care

55:25 – Medicaid federal matching rates and state competitiveness

56:38 – How Democrats and Republicans engaged at the hearing

58:57 – The politics of why nothing gets done


Links:

YouTube Dr. Digiorgio Congressional Testimony: https://www.youtube.com/watch?v=sjPr3fK9jjc

Written Testimony

@anish_koka | @drdigiorgio

@drsloungepod

🎧 Spotify | Apple Podcasts | YouTube


In The Doctor's Lounge, the white coat comes off for a conversation that moves freely from the exam room to the boardroom. This isn't a lecture hall; it's the back table where practicing physicians gather to unpack the complex systems that define modern medicine. Hosted by Dutch Rojas and Anthony DiGiorgio, DO, with regular voices like Anish Koka, MD, Dan Choi, MD, and Sanat Dixit, MD, the discussions are built on frontline experience. You'll hear unfiltered perspectives on the policy debates that shape care, the realities of navigating business and entrepreneurship within a medical practice, and the constant push for meaningful reform. The dialogue is grounded in a shared commitment to physician autonomy and, ultimately, better patient outcomes. Each episode in this podcast connects the dots between clinical fitness and the health of the medical profession itself, offering a rare look at the challenges and opportunities that exist where patient care meets the mechanics of the healthcare industry. It's a space for the nuanced, often contentious, and always real conversations happening behind the scenes.
Author: Language: English Episodes: 49

The Doctor's Lounge
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