The U.S. District Court from the District of Columbia ruled on March 7, 2006 that the Renal Physicians Association (RPA), a national non-profit specialty society of dialysis facility medical directors, lacked standing to challenge the Stark regulations regarding fair market value compensation.

RPA filed suit on January 14, 2005, alleging that the regulations violated the statutory mandates of the Stark Act and were issued without proper notice. The Court dismissed the Complaint, stating that the remedy sought by RPA, i.e., invalidation of the fair market value regulations, would not accomplish the RPA goal of allowing higher compensation and suggested that the proper process would be to petition HHS or Congress. The Court stated that it was mere speculation that invalidation of the regulations would provide the relief sought, analyzing the situation in footnote 6 to attempting to put Humpty Dumpty back together again. Renal Physicians Association v. U.S. Department of Health and Human Services, CCH Medicare and Medicaid Guide 301,800.