Purpose

• This memorial urges federal action to undo certain waivers and change payment rules so clinics and hospitals can freely choose whether to enter into contracts that depend on the volume of care they provide.

Main provisions

• Urges the President to direct the Federal Trade Commission (FTC) to repeal waivers of antitrust laws.
• Urges the Centers for Medicare and Medicaid Services (CMS) to repeal waivers of antifeesplitting and antiselfreferral laws.
• Urges Congress to amend the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to require that clinics and hospitals have freedom to contract or not contract for payments contingent on the volume of orders for care.
• Directs the Secretary of State to transmit copies of the memorial to federal leaders, including the President, leaders of Congress, and relevant federal officials.

How this would change existing law

• Repealing antitrust waivers would restore stricter enforcement against collusion, price fixing, and other anti-competitive practices in health care markets.
• Repealing waivers for antifeesplitting and antiselfreferral would limit or prohibit arrangements that currently allow certain referrals to be driven by financial incentives rather than patient need.
• Amending MACRA to allow payment contracts that depend on the volume of care would permit or encourage payment models where providers take on more financial risk tied to how much care is ordered or delivered.

Context and rationale (from the bill’s premises)

• The text argues that current federal waivers enable government-backed cartels and risk-sharing schemes among large payer and provider entities, which it claims undermines antitrust laws and leads to higher costs or lower quality care.
• It contends that pay-for-volume or volume-contingent payment schemes create conflicts of interest, encourage gatekeeping, and may violate existing professional and federal rules against improper incentives.
• The memorial frames past attempts at pay-contingent models as ineffective for controlling costs or improving quality, and asserts that removing waivers would restore patient protections and professional integrity.

Practical implications to consider

• If adopted, this memorial would push federal agencies and Congress to reduce or remove waivers and to broaden providers’ ability to choose payment terms, potentially affecting how care is financed and delivered in Minnesota and nationwide.
• It highlights a focus on antitrust enforcement, referral patterns, and payer-provider contracts as central issues in health care cost control and quality.

Relevant Terms antitrust waivers, antifeesplitting waivers, antiselfreferral waivers, Federal Trade Commission (FTC), Centers for Medicare and Medicaid Services (CMS), Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), freedom to contract, payments contingent on the volume of orders for care, volume-based payments, capitation, accountabl e care organization (ACO), referrals, gatekeeping, collusion, price fixing, denials of care, pay-for-volume, cartels, provider insurance corporations, bilateral contracts, public interest in patient protections.