The 2025–2026 legislative session has produced two major regulatory oversight bills regarding private equity in healthcare. SB 351, introduced by Senator Christopher Cabaldon (D) on February 12, 2025, and currently set for its second hearing, focuses on strengthening California’s ban on the corporate practice of medicine. Similarly, AB 1415, authored by Assemblymember Mia Bonta (D), seeks to expand the authority granted to the Office of Health Care Affordability (OHCA) in monitoring healthcare transactions. Below we discuss the intricacies of each bill, the potential impact on the state’s healthcare market, and […]

Healthcare Consolidation Partnerships Between Pharmaceutical and Telehealth Companies – Increasing Access or Driving Inappropriate Prescribing? (The New England Journal of Medicine) Erin C. Fuse Brown, Oliver J. Wouters, Attev Mehrotra As technology has progressed, so too have health care delivery mechanisms for Americans. However, an emerging collaboration between pharmaceutical companies, like Pfizer and Eli Lilly, and telehealth companies is leaving many divided. Pharmaceutical companies have evolved their marketing and disbursement practices by increasingly using social media marketing to now directly link to telehealth providers who connect healthcare consumers with a […]

Department of Justice Looking Into United Health On February 21, 2025, the Wall Street Journal reported that the Department of Justice (DOJ) has launched a civil fraud investigation against UnitedHealth.  The investigation is centered on Medicare billing practices, with sources saying that UnitedHealth-employed physicians were trained to document higher revenue-generating diagnoses, even if that was not what patients were being treated for.  Additionally, the investigation is apparently looking into claims that UnitedHealth used software to suggest additional codes and offered bonuses to clinicians who coded for these additional diagnoses.  If […]

Private Equity in Healthcare The Rise of Private Equity in Health Care  — Not a Uniquely American Phenomenon (The New England Journal of Medicine) Yashaswini Singh, Erin Fuse Brown, and Irene Papanicolas Private equity investment in the United States has become an increasingly hot topic – with many debating whether the industry’s prioritization of short-term profitability over long-term investments make it an appropriate fit for patient care. While the issue of private investment in healthcare may appear to many to be a uniquely American phenomenon, given this country’s market-based system, […]

On December 23, 2024, Aetna (part of CVS Health) filed a lawsuit against Radiology Partners and its private equity backers in the U.S. District Court for the Middle District of Florida – Jacksonville Division.  The suit claims Radiology Partners, one of the nation’s largest imaging groups, manipulated the No Surprises Act (NSA) and its dispute resolution process to boost payments improperly.  Aetna’s filing called this a “multiphase healthcare fraud scheme” that defrauded Aetna of “tens of millions” of dollars. Update: On February 25, Radiology Partners filed two motions: one to […]

Healthcare Pricing Can Public Option Plans Improve Affordability? Insights From Colorado (Health Affairs Forefront) Roslyn Murray, Christopher M. Whaley In the face of individuals and families unable to afford increasing insurance premiums due to lack of healthcare insurance competition, a variety of states are considering offering public option plans, commonly for ACA Exchange plans. These plans seek to provide coverage with low premiums by means of capped prices for those who do not meet Medicare or Medicaid requirements nor receive private coverage through employment. The article describes Colorado’s effective public […]

The California legislation concluded the 2024 legislative session when it adjourned on August 21, 2024. Overall, the legislature introduced a variety of health care bills spanning a list of hot-topic issues from Medi-Cal eligibility to health care worker minimum wage increases. Below we recap noteworthy bills from the 2024 legislative session impacting California’s health care market that were not enacted (to learn what bills were enacted please see Recapping the 2024 California Legislative Session: Artificial Intelligence, Debt, and More). The bills covered are arranged by issue relating to Pharmaceuticals, Health […]

Healthcare Competition and Consolidation Chang(ing) Health Care: Bigger May Not Be Better, Just Necessary (Health Affairs Forefront) Atul Grover, Jonathan B. Jaffery As the health care market increasingly trends towards consolidation, many have been left wondering whether the trend towards amalgamated efficiency truly is better. The authors of a new Health Affairs article are arguing that the answer is no. Specifically, they state that the trend towards larger, more consolidated entities is resulting in higher health care costs without marked improvements to quality. As health systems become larger, their power […]

On September 28, 2024, Governor Gavin Newsom vetoed Assembly Bill (AB) 3129. The landmark bill would have added restrictions around how private equity groups (PEGs) and hedge funds could participate in the ownership and management of California healthcare facilities. Introduced by Assemblymember Jim Wood and Attorney General (AG) Rob Bonta this past February, supporters of the bill had been optimistic about the bill’s potential impact on healthcare consumers and on the broader healthcare market. In this month’s California Legislative Beat, we examine how this bill could have changed healthcare transactions […]

Healthcare Competition and Consolidation The Rise of Health Care Consolidation and What to Do About It (Health Affairs Forefront) Erin C. Fuse Brown, Yashawini Singh, Christopher M. Whaley, Jared Perkins As hospital consolidation continues to meteorically rise, an increasing number of government institutions including the Federal Trade Commission, the Department of Justice, and Congress, have diverted move resources towards understanding and responding to the negative impacts of these trends. The drive towards health care consolidation began in the 1990s and has resulted in a highly concentrated hospital market.  Increased consolidation […]