The Omnibus Budget Reconciliation Act (OBRA) of 1989, “Stark I,” and OBRA 1993, “Stark II,” contain provisions introduced by Rep. Fortney “Pete” Stark of California that limit certain referral and compensation arrangements for physicians. Since some of these restrictions affect the practice of orthopaedic surgeons and the nurses employed in these practice settings, this article provides general information related to the Stark self-referral legislation.