The 1989 Stark Law penalizing physicians and hospitals for making medical decisions for patients based on their financial self-interest has few remaining fans. Even its author, former California Democratic Rep. Pete Stark, has called for repealing the law, which has metastasized in complexity over 30 years. Now the Trump administration, backed by provider groups, is poised to make what CMS Administrator Seema Verma called “the most significant changes to the Stark law since its inception.”