Enacted more than two decades ago to curb physician self-referral, Stark Law has evolved to become so complex that health system CEOs and even the law's namesake are calling for its repeal. In 1989, Congress passed the Ethics in Patient Referrals Act, which was dubbed Stark I after Congressman Pete Stark, who sponsored the initial bill. The original statute was quite simple. It sought to ban physician self-referral for designated services when a patient was covered by Medicare or another government payer. Self-referral occurs when physicians refer patients to hospitals, labs and other entities from which they benefit financially. The...