The Stark Laws, named after sponsoring California Congressman Pete Stark, attempt to solve a problem that nobody has proved exists: that if physicians own diagnostic machines, the profit motive will cause them to refer too many patients for too many MRIs, CT scans, and PET scans.  Health Affairs has published a scholarly article showing that in California (where state law is actually stricter on self-referral than the federal Stark laws), physicians have found ways around the rules - and AG's are going after them.

One way is for a 3rd party to "own" the machines, but lease them to the physician in such a way that the physician actually bears the economic risks of ownership. (This sort of thing is quite common in real estate, where "sale and leasebacks" are used to shore up balance sheets.)

No doubt this will cause Representative Stark to start a flurry of legislative activity to close these "loopholes", which will all be in vain.  Physicians will always be one step ahead of the legislators and regulators who try to thwart their self-interest.

Plus, there is no way to determine whether physicians self-refer out of greed, or invest in diagnostic machines in good faith because of their value to patients.  The best "regulator" is the informed, empowered patient, who controls the payments, not a government bureaucracy.

Stark laws simply make ownership more opaque, and raise health costs because physicians have to hire lawyers and accountants to help them preserve their ownership of their profession.

Repeal the Stark laws, don't increase their burden.