STATE LEGISLATIVE UPDATE

TABLE OF CONTENTS

SECTION 1: ANTITRUST AND MERGER REVIEW
Merger Review and Approval
Merger Notification
Certificate of Need
Other

SECTION 2: RATE REGULATION AND COST CONTROL
Benchmarks and Caps
Facility Fees and Site Neutrality
Transparency

SECTION 3: PROVIDER CONTRACTING AND NONCOMPETE CLAUSES
Insurer Imposed Conditions
Health System Imposed Conditions

SECTION 4: HEALTHCARE SYSTEM REFORM

SECTION 5: MISCELLANEOUS
Private Equity/Corporate Practice of Medicine
Fiduciary Duties/Third Party Administrators
Artificial Intelligence
Other

Downloadable PDF

Illinois – SB1998 would require healthcare facilities or provider organizations to notify the AG at least 30 days before any mergers or new affiliations. The bill adds that the AG must provide written consent if a private equity group is providing financing for the transaction. The AG would be given power to investigate the transaction.

Massachusetts – H1355 would expand the Health Policy Commission’s authority to review and potentially block mergers, acquisitions, and expansions by healthcare organizations. Entities that have exceeded cost growth benchmarks would be required to file performance improvement plans. Previously approved material changes would be reviewed annually to determine if lower costs and improved quality have been achieved.

North Carolina – S532 would establish the Preserving Competition in Healthcare Act. The bill would require notice to the State Auditor, AG, and State Treasurer before hospital entities could engage in any sale, transfer, or change of control of assets worth more than $5 million. Proposed transactions would be jointly reviewed, which would include public hearings, and would be evaluated on patient access, community benefits, potential conflicts of interest, and potential effects on healthcare providers. Reviewing officials can file a legal action to block or modify any deals found to be objectionable. Additional scrutiny would be imposed on deals involving nonprofit or publicly owned hospital to ensure community benefits are protected.

New York – A06056 would require healthcare providers looking to engage in mergers and acquisitions to be evaluated by the Public Health and Health Planning Council to determine if the transaction would improve access to medical care for underserved individuals, lower costs, and advance public health goals. For five years after the transaction, approved providers would be prevented from raising charges beyond the medical care consumer price index, and would have to submit annual reports showing how the merger has improved prices, outcomes, or efficiencies.

Pennsylvania – SB708 would require healthcare facilities to notify the AG before entering into mergers, acquisitions or substantial asset transfers. The AG would be empowered to conduct public hearings, request additional information, and potentially enjoin transactions deemed against the public interest.

Pennsylvania – HB1266 would require potential hospital acquirers to provide detailed information to the Department of Health, who would approve or deny acquisitions based on whether they will maintain accessible and affordable healthcare for local communities. The bill also requires monitoring of acquisitions for at least 10 years to ensure any commitments made during the approval process were upheld.

Washington – SB5704 would require parties to a healthcare material change transaction to submit detailed notices that assess potential impacts on community health services. Public hearings would be required, and the AG would have the ability to approve, modify, or disapprove transactions and to impose penalties for non-compliance. The bill would require ongoing monitoring for five years after the transaction.

Colorado – SB198 would have required parties to a merger, acquisition, or contracting affiliation to submit detailed written notice to the AG 60 days before the transaction’s effective date. The AG would have the ability to block transactions that are contrary to the public interest.

Connecticut – HB05592 would have incorporated federal merger guidelines into state law and authorized the AG to take action against mergers that violate the federal guidelines.

Connecticut – HB06873 would have required health care entities engaging in mergers, acquisitions, affiliations, or transfers of ownership or control to notify the AG 60 days prior. The bill would have expanded the powers the AG has to evaluate the transactions for potential impacts on healthcare access, quality, and affordability, and the AG would have been empowered to propose conditions or require a certificate of need.

Louisiana – HB607 would have required a hospital service district to obtain explicit written consent from the hospital service district where it intends to establish a new facility, and provide a detailed 120-day advance notice. The affected hospital service district’s governing board would have to issue a resolution of consent before the expansion could occur.

Maine – LD1972 would have required healthcare entities to get Department of Health and Human Services approval for material changes transactions of $10 million or more. The Department would conduct a preliminary review, but could do a more comprehensive review for transactions that impact cost, competition, quality, or access. The Department would have been authorized to approve, disapprove, or conditionally approve transactions.

New Mexico – SB14 would have required healthcare entities planning transactions about a particular threshold to submit notice with the Office of the Superintendent of Insurance which would include potential impacts on essential services, patient care, employee working conditions, and market competition. Transactions could not be completed without the approval of the Superintendent, who can approve, disapprove, or allow with conditions, based on potential effects on cost, quality, and accessibility. Post-transactions reports on the effects of the transaction would also need to be submitted.

Oregon – HB3234 would have given the AG power to investigate and act against insurers if they are potentially creating monopolies, restraining trade, or engaging in other trade practices that harm healthcare access.

Texas – HB2747 would have required healthcare entities to notify the AG before mergers, acquisitions, joint ventures, or sales of substantial assets. The AG would have been empowered to conduct studies to determine the impact of the proposed transaction.

Utah – HB0466 would require businesses to electronically file their Hart-Scott-Rodino forms with the AG if they meet certain criteria. The AG could take action on a pre-merger notification.

California – AB1415 would expand reporting requirements, with healthcare entities giving written notice to the Office of Health Care Affordability about significant agreements or transactions involving material changes in assets, ownership, or control. The bill also expands the Office’s ability to study the impact on cost, quality, and workforce of various healthcare entities. The bill also includes new definitions of hedge fund and management services organization.

Colorado – SB126 establishes the Uniform Antitrust Pre-Merger Notification Act. The act requires business to file a copy of their Hart-Scott-Rodino (HSR) pre-merger notification form with the AG if their principal place of business is in the state, or if they meet minimum in state sales requirements.

New Mexico – HB586 establishes a review process for hospital and healthcare provider transactions. Parties are required to submit detailed notices to the Health Care Authority before completing such transactions, and the Authority is charged with conducting a review that considers access to essential services, market competition, and potential impact to costs, and quality.

Washington – SB5122 creates the Uniform Antitrust Premerger Notification Act, requiring businesses that have to file pre-merger notifications under the federal Hart-Scott-Rodino Act to also file copies with the state AG if their principal place of business is in the state, or if they meet minimum in state sales requirements.

California – SB25 would require any business already required to submit a Hart-Scott-Rodino premerger notification with the federal government to also file a copy with the California AG, if the business has their principal place in business in the state, or annual net sales in California at 20% or more of the federal filing threshold.

Hawaii – SB348 establishes a Uniform Antitrust Pre-Merger Notification Act, requiring businesses to file copies of their Hart-Scott-Rodino (HSR) pre-merger notification forms with the AG, if their principal place of business is in the state, or if they meet minimum in state sales requirements.

Massachusetts – H3947 would create new requirements for healthcare insurance and service organization mergers. The bill would require specific conditions to be met before the state insurance commissioner can approve the merger, including that the merger agreement must filed with the state 60 days prior, and a public hearing will be held if requested by various state agencies or at least 10 state taxpayers.

Vermont – H0071 prevents corporations from interfering with the clinical judgement of medical professionals, and prevents non-medical entities from controlling medical practices. It also requires healthcare entities to inform the state before any material change transaction (mergers, acquisitions or partnerships) of over $1 million or more. The bill would also require physicians to have majority ownership and control of medical practices, and would void any non-competition and non-disclosure agreements that could restrict rights.

Connecticut – SB00837 When group practices are already required to provide notice of material changes to the AG, this bill would have also required them to submit information to the Commissioner of Health Strategy. The bill would have also requested development of legislative recommendations for increased oversight of group practice mergers and acquisitions.

Indiana – HB1632 would have required merging healthcare entities with total assets of over $10 million to provide written notice to the AG at least 90 days before the transaction is completed. The AG is authorized to analyze the transaction for antitrust concerns.

Nevada – SB218 would have enacted the Uniform Antitrust Pre-Merger Notification Act, requiring businesses that have to file pre-merger notifications under the federal Hart-Scott-Rodino Act to also file copies with the state AG if their principal place of business is in the state, or if they meet minimum in state sales requirements.

West Virginia – HB2110/SB32 establishes the Uniform Antitrust Pre-Merger Notification Act, requiring businesses that have to file pre-merger notifications under the federal Hart-Scott-Rodino Act to also file copies with the state AG if their principal place of business is in the state, or if they meet minimum in state sales requirements.

Hawaii – HB11 would eliminate the certificate of need requirement for most health facilities and services, with the exceptions of nursing homes, hospices, intermediate care facilities, and ambulance services.

Iowa – HF224 would eliminate certificate of need requirements.

North Carolina – H455 would repeal the state’s certificate of need laws.

North Carolina – S370 would repeal the state’s certificate of need laws.

Nebraska – LB437 would repeal the Nebraska Health Care Certificate of Need Act.

Rhode Island – H5355 would have repealed the “Health Care Certificate of Need Act of Rhode Island.”

Connecticut — SB00709 would have eliminated the states certificate of need program.

Connecticut — HB05195 would have amended existing certificate of need requirements, removing the requirement to obtain one when transferring ownership of healthcare facilities or establishing new facilities and services. A certificate would still be needed only for the termination of existing facilities and services.

Maine — LD743 would have eliminated the state’s certificate of need requirements.

Missouri — HB1240 would have repealed the state’s entire certificate of need law.

Mississippi — SB2682 would have repealed the state’s entire certificate of need law.

Virginia — SB910 had proposed a three-stage elimination of the state’s certificate of public need requirements, allowing a gradual adjustment to prepare for full repeal.

West Virginia — HB2007/SB453 would have repealed the state’s certificate of need program.

West Virginia — HB3308 would have eliminated the West Virginia Health Care Authority and terminated the certificate of need program.

California — AB1345 expands the definition of anticompetitive practices under the Cartwright Act, making it unlawful for one or more persons to take actions that restrain trade, impede free competition, or attempt to monopolize or monopsonize trade or commerce.

Minnesota — SF2025 establishes the Fair Competition Act to address anti-competitive business practices by prohibiting the establishment or maintenance of monopoly or monopsony power that affects competition or controls prices. The bill broadens the scope of existing antitrust law by creating new legal standards for price fixing, market allocation, and collusive practices. The bill also creates a prohibition on unconscionably excessive prices (defined as prices 10% above recent market rates) and a ban on price discrimination that could potentially lessen competition or create monopolistic conditions.

New York — A02015/S00335 would significantly expand existing New York anti-trust laws. The definition of monopolistic and anti-competitive practices would be amended to include unilateral actions by dominant firms that harm market competition. The bill also would make it easier to establish a company’s dominant market position, including presumptions based on market share and allowing direct evidence of market dominance. The bill would also require notification to the AG when companies are involved in significant mergers.

Oklahoma — HB1415 would expand who can bring an antitrust lawsuit by allowing for claims for injuries that are direct or indirect. The Attorney General would be empowered to bring civil actions on behalf of the state, governmental entities, or residents.

Pennsylvania — HB1371 prohibits anticompetitive practices, creating antitrust regulations that allow the Attorney General to take action against entities engaged in activities that restrain trade, monopolize markets, or create anti-competitive mergers. Health care facilities, health care systems, and provider organizations would have to provide premerger notifications to the Attorney General. Others that suffer damages from anticompetitive practices can bring civil actions, and the law allows for class action lawsuits.

Pennsylvania — SB754 establishes comprehensive requirements for hospitals planning to close all or a significant portion of their operations. Hospital authorities would be required to obtain approval from the Attorney General and either the state or local health department before closure, to ensure that patient care continuity and community health needs are adequately addressed.

Connecticut — SB00010 – Among other things, the bill empowers the Insurance Commissioner to reduce premium rate increases that exceed healthcare cost growth benchmarks.

Indiana — HB1004 requires nonprofit hospital systems to submit detailed financial information to the state, and mandates that nonprofit hospital systems’ aggregate average prices must be at or below the statewide average.

Massachusetts – H1376 would create a cost growth benchmark, setting a target for annual increases in healthcare spending. The total assessed amount for a variety of healthcare entities could not increase at a rate higher than the benchmark approved by the Health Policy Commission.

Massachusetts – H1361 would allow the Health Policy Commission to implement performance improvement plans from healthcare entities that exceed spending benchmarks. The state would also perform an analysis of healthcare spending, referring entities with excessive spending to the Commission. The commissioner would also get authority to review rates, and have authority to approve, modify, or disapprove rates that appear excessive, inadequate, or unfairly discriminatory.

Massachusetts – H1372/S905 creates the Weighted Average Payer Rate – a calculation that determines inpatient and outpatient revenue per discharge/visit for different types of payers. Requiring reporting on the index is intended to increase transparency, and the state’s healthcare commission would be required to hold annual public hearings on healthcare expenditure growth, costs, payment systems, and delivery systems.

Massachusetts – S2047 reforms the state’s healthcare cost benchmark in Massachusetts by creating a new definition of “historical growth rate in gross state product” as the average annual growth rate of the gross state product measured over a ten-year period.

Massachusetts – S904 modifying how the state’s Health Policy Commission is able to address excessive healthcare spending. Entities that have been identified as exceeding the cost growth benchmark may be required to develop a performance improvement plan to reduce spending. If the entity fails to implement the plan in good faith, civil penalties can be imposed.

Massachusetts – H1384 creates a three-year benchmark cycle to monitor healthcare expenditure growth. Entities that exceed the benchmark would be required to develop performance improvement plans, with civil penalties for repeated violations.

Minnesota – SF622 allows insurance carriers to offer reference-based pricing health plans, where the carrier sets a predetermined rate for services based on a percentage of Medicare rates, rather than negotiating separately with providers. Providers would decide if they wanted to accept the specified rate, and would not be required to participate in a reference-based plan.

Oklahoma – SB787 limits payments for hospital services to either 200% of Medicare/Medicaid rates or the median amount paid by health benefit plans, whichever is less. Providers could not charge patients more than authorized cost-sharing amounts. Insurance rate filings would be reviewed for affordability, and the ability of lower-income individuals to pay for health insurance.

South Carolina – H3302 prevents insurers from charging higher out-of-pocket rates for emergency services from out-of-network providers compared to in-network services and would require reimbursement of out-of-network providers at either the in-network rate, the usual and customary rate, or the Medicare reimbursement rate, whichever is greatest. The legislation would define surprise billing as an unfair trade practice.

New Mexico – SB512 would have changed how the surprise bill reimbursement rate is calculated, from using 2017 data to using data from two years prior to the service date, with the reimbursement rate set at 60 percent of comparable allowed commercial reimbursement rates, but cannot be less than 150% of the Medicare rate for the service.

Rhode Island – H5832/S0681 would have required the Rhode Island Office of Health Insurance Commissioner to review and approve population-based and hospital contracts if their annual cost increases exceeded the Consumer Price Index for all Urban Consumers (CPI-U) percentage increase.

Illinois — HB1431 amends the Fair Patient Billing Act to require hospitals to transparently inform patients about facility fees charged for outpatient services. The AG is empowered to investigate potential violations, with monetary penalties that can escalate to potential adverse licensure action if violations are repeated.

Illinois — SB2182 creates the Facility Fee Transparency and Prevention Act. The Act would prohibit facility fees for preventive services and preventive care. For other services, patients would need to be informed in advance about specific facility fees.

Massachusetts — H1144/H4619 limits where providers can charge facility fees to services on hospital campuses or emergency departments. Clear written notice of facility fees would need to be provided to patients. Additionally, the bill would create requirements for notifying patients when services are out-of-network.

Minnesota — HF1312/SF1503 would prevent providers from charging facility fees for specific types of services at provider-based clinics. Providers would not be allowed to charge facility fees for outpatient evaluation and management services.

North Carolina — S316 would require hospitals and ASCs to disclose detailed cost information for common medical procedures and inpatient admissions, and require that patients be informed about potential out-of-network providers. The bill would also place limits on facility fees, and require reporting of facility fee practices.

New York — A05342/S08039 would prohibit providers from charging facility fees that aren’t covered by the patient’s insurer by removing existing statutory language that allowed facility fees with advanced notice.

New York — A02140 would create site-neutral payment policies for certain healthcare services. The bill would require providers participating in health benefit plans to accept rates that do not exceed 150% of Medicare rates for enumerated services.

Connecticut — SB00839 would have defined facility fee collection (where hospitals impose additional charges for services rendered at hospital-affiliated outpatient locations) as an unfair trade practice.

Connecticut — SB00819 would have required insurers to reimburse providers in a site-neutral fashion, where the payment for services is the same regardless of where it is performed, such as a hospital-owned clinic instead of an independent medical office.

Oregon — SB539/HB2148 would have required hospitals to report information about facility fees to the Oregon Health Authority, and hospitals would have to provide written notice to patients about facility fees in advance of treatment, including explaining the patient’s right to request a fee reduction.

Texas — HB3321 would have required healthcare entities to provide notices to patients about potential additional charges, including facility fees, and develop a waiver process allowing patients to reduce facility fee costs. Entities would have been prohibited from charging facility fees for services provided outside their main campus or for certain evaluation and management procedures.

Texas — HB2556/SB1232 would have required providers to give written notice of facility fees to patients before treatment, and providers would have to inform payors before introducing new facility fees. Providers would not have been allowed to charge facility fees for telehealth services.

Texas — HB2075 would have prevented providers from charging facility fees, with the exceptions of services provided on a hospital campus and emergency care services.

Texas — HB985 would have required hospitals to provide written notice to the state if they acquire an outpatient health care facility. The law would also require reimbursement rates for these facilities to be equal to those of independent physician-owned practices where there is no reliance on special facility technology and there is no evidence-based reason for a different rate.

Vermont — S0030 updates and reorganizes Vermont health insurance statutes to provide more comprehensive consumer protections, ensure transparency in health insurance practices, and align Vermont’s health insurance regulations with current federal standards and best practices.

New Jersey — A382 requires providers to disclose to patients if they are in or out of network, and to obtain written consent when patients use out-of-network providers. Disputes over balance billing would be resolved by newly established peer review panels.

Arkansas — HB1426 amends existing law to expand the definition of “healthcare insurer” to include third-party administrators and other entities acting on behalf of self-insured health benefit plans. The bill also bans all-product clauses, and prevents enforcement of any clauses with the same effect. Additionally, the bill modifies rules around leasing or sharing healthcare contracts and provider networks to require more transparency and to give healthcare providers the ability to decline participation in these arrangements.

Indiana — H1003 among other things, prevents contracts that require a health carrier to place all facilities in the same tier of a tiered network plan, to include all facilities in a select network plan on an all-or-nothing basis, to participate in a new select network or tiered network plan that the health carrier introduces without granting the provider the right to opt out.

Texas — HB1959/SB926 allows insurers to use incentives like modified deductibles or copayments to encourage patients to use particular providers. The bill adds that payors have a fiduciary duty to act in the best interests of patients and policyholders when creating incentives or ranking physicians. The bill adds transparency requirements in how physicians are ranked.

Massachusetts — S851 states that a healthcare provider can’t refuse to negotiate in good faith with payors, then subsequently charge extremely high rates for non-contracted services (defined as more than 200% of the payor’s average contracted reimbursement rate for that same service).

New York — A05106/S07577 would prevent insurers from being required to include all members of a provider group in their network, place all group members in the same network tier, or include all group members in all of their insurance products. Contracts couldn’t prohibit insurers from encouraging patients to seek care from higher-value providers using benefit design, and from including most-favored-nation clauses.

Washington — HB1589/SB5588 would require carriers to give providers a meaningful change to engage in good faith negotiations. The bill would also prohibit “all-or-nothing” contract clauses.

Arkansas — SB221 would have prevented risk-based provider organizations (healthcare entities that manage shared savings) from using “tying” or “all or nothing” tactics, where providers are forced to accept contract terms for all services or get removed from the network, to force providers to contract for multiple services against their will.

Connecticut — HB07116 would have prohibited a variety of restrictive clauses in healthcare contracts, including a new prohibition on revenue neutrality clauses, which require health carriers or plan administrators to protect healthcare providers from potential economic losses. Also banned would be all-or-nothing clauses, anti-steering clauses, anti-tiering clauses, and gag clauses.

Maine — LD1713 would have banned anti-steering clauses, anti-tiering clauses, and all-or-nothing clauses. Carriers were allowed to sue providers who violate the provisions, and the AG would have been empowered to investigate potential violations.

Montana — LC0304 would have prohibited six types of problematic contractual clauses including most-favored-nations clauses, anti-steering clauses, anti-tiering clauses, all-or-nothing clauses, gag clauses, and all-products clauses. Any carriers, providers, or plan administrators who include these clauses in contracts would be considered engaged in unfair trade practices.

Texas — HB4992 would have prohibited exclusive dealing clauses and tying clauses in healthcare provider network contracts. Contract provisions with these clauses would be considered void and unenforceable, although the rest of the contract would have remained valid.

Virginia — HB2274 would have required licensed outpatient facilities to be included in insurers preferred provider networks. It would have added provisions allowing for provider to sue insurers who discriminate or breach contract provisions.

Arkansas — SB139 makes any noncompete agreement restricting a physician’s ability to practice within their professional scope of practice automatically void, but maintains existing protections for trade secrets. Noncompete agreements outside of employment (including business sales or franchise agreements) are not affected.

California — SB351 prohibits private equity groups from interfering with healthcare clinical decision making, but also prevents the investment groups from exercising control over non-clinical aspects, including staffing, relationships with payers, and billing decisions. The bill includes invalidating healthcare provider noncompete and nondisclosure clauses.

Colorado — SB083 clarifies and expands restrictions on non-compete agreements, specifically for highly compensated workers and healthcare providers. The bill contains exceptions for highly compensated workers protecting trade secrets and for scenarios such as business sales, if these provisions do not overly restrict workers’ ability to use their general knowledge and skills. The bill introduces a formula for calculating the duration of non-compete agreements for business ownership situations that is based on the total consideration received versus average compensation.

Indiana — SB0475 prohibits physicians from entering into noncompete agreements, including any contract provisions that restrict a physician’s ability to practice medicine after leaving an employer. Exceptions are included, including to protect business confidential information, limited nonsolicitation agreements, and agreements made during the sale of a business entity. The law only applies to new agreements entered into after July 1, 2025, and does not affect pre-existing noncompete agreements.

Kansas — SB241 establishes a presumption that several categories of written covenants are legally valid, including non-solicitation agreements.

Montana — HB620 prohibits contract clauses that restrict physicians from practicing after leaving a job. Previously, the law only prohibited these clauses for psychiatrists and addiction medicine physicians. The law also prevents employers from prohibiting physicians from soliciting patients from their previous workplace. The law will apply to contracts made or renewed after January 1, 2026.

Montana — HB198 expands the law addressing clauses that restrict healthcare providers professional practices after they leave employment to include additional professionals such as naturopathic physicians, registered professional nurses, advanced practice registered nurses, and physician assistants. The law does not apply to contracts related to the sale and purchase of a medical practice, and applies to contracts made or renewed after its effective date.

Oregon — SB951 prevents management service organizations from controlling a majority of medical practice shares, or controlling any clinical decision-making. The bill also makes nondisclosure, and nondisparagement agreements viod and unenforceable for medical professionals.

Texas — HB4504/SB1318 establishes requirements for physician noncompete agreements, including limiting the geographical area to a five-mile radius from the physician’s primary practice location, ensuring the agreement expires within one year of contract termination, providing patient access to medical records, and allowing a “buyout” option where the physician can end the agreement by paying an amount not exceeding their annual salary. Similar provisions apply to other healthcare providers. Noncompetes are void if a physician is discharged without “good cause”. Existing agreements remain under previous standards, with the changings only applying to agreements entered into (or renewed) after September 1, 2025.

Wyoming — SF0107 creates a broad prohibition against noncompete agreements with several key exceptions. Exceptions include business sale agreements, protecting trade secrets, recovering a portion of employee training and relocation expenses, and executive, management, and professional staff positions. For physicians, the bill completely prohibits noncompete provisions restricting the ability to practice medicine after ending employment. Physicians would be allowed to disclose their continued medical practice and contact information to patients with rare disorders whom they previously treated. The law would not affect existing agreements made before July 1, 2025, and only applies to new agreements.

Michigan — HB4514 would change the Michigan Antitrust Reform Act to add a new prohibition against noncompete agreements specifically for physicians.

Michigan — HB4040 intends to restrict noncompete agreements prohibiting businesses from enforcing them, with exceptions that include when a worker is selling their ownership stake. Businesses are still allowed to protecting legitimate interests, such as trade secrets.

North Carolina — S673 prevents employment contracts from containing noncompete clauses for healthcare professionals employed by hospitals, or terms that prevent professionals from providing practice information on patient request. The bill also adds whistleblower protections for healthcare professionals, and restricts nondisclosure agreements so professionals can report concerns with safety, ethics, and illegal activities.

New Jersey — S4386 would prohibit non-compete clauses and no-poach agreements, declaring them unenforceable, including terms already in place. The bill also prevents employers from charging departing employees for repayment of training costs, replacement hire fees, or similar financial penalties.

New Jersey — A5708/S4385 would prohibit non-compete clauses for most workers, with exceptions for senior executives (defined as those in policy-making positions earning at least $151,164 annually) and for noncompete clauses related to the sale of a business. The bill would also prohibit “no-poach” agreements to prevent employers from hiring each other’s employees.

New Jersey — A1819/S4068 makes noncompete agreements for physicians and nurses unenforceable, with exceptions such as covenants that prohibit a physician from leaving a large hospital system or group practice to join another, or from leaving a federally qualified health center to practice within a five-mile radius for up to four years. or where the physician was provided a unique incentive, like a significant signing bonus, to join the system.

New York — S04641 would prohibit noncompete agreements for most workers, declaring them null and void. There would be exceptions for workers earning over $500,000 annually, and for protecting trade secrets, confidential information, client solicitation, and in specific business sale scenarios. The bill also prevents employers from using alternative legal strategies, such as choosing a different venue, to circumvent its protections.

South Carolina — S0046 would prohibit contract terms that limit healthcare professionals’ ability to treat patients, practice in certain geographic areas, or maintain patient relationships after leaving employment. Exceptions include repayment of relocation or recruitment expenses, and protection of legitimate business interests like trade secrets. The prohibition would apply to contracts entered into or renewed after its effective date.

Tennessee — HB1034/SB0995 would broadly prohibit non-compete agreements, rendering restrictions on the right to practice professionally after terminating employment void and unenforceable. The bill specifically removes existing language that allowed noncompetes related to healthcare. The bill would apply to contracts entered into (or amended) on or after July 1, 2025.

Vermont — H0334 would restrict noncompete agreements and stay-or-pay provisions. Most noncompete agreements would be void, with exceptions for sale of a business, partnership dissolution, or limited liability company termination. Stay-or-pay provisions (which require employees to repay certain costs if they leave their job) would be generally unlawful, but with exceptions for specific, limited, conditions.

Vermont — H0071 prevents corporations from interfering with the clinical judgement of medical professionals, and prevents non-medical entities from controlling medical practices. It also requires healthcare entities to inform the state before any material change transaction (mergers, acquisitions or partnerships) of over $1 million or more. The bill would also require physicians to have majority ownership and control of medical practices, and would void any non-competition and non-disclosure agreements that could restrict rights.

Washington — HB1155/SB5437 prohibits noncompetition agreements, rendering them void and unenforceable regardless of when they were originally signed. Nonsolicitation agreements would still be permitted, but must be narrowly construed.

Arizona — HB2589 would have prohibited employers from requiring employees to sign noncompete clauses, effectively making such noncompete clauses unenforceable in the state.

Connecticut — SB00354 would have repealed existing sections of the law that currently place restrictions on noncompete agreements in private employment contracts, making it easier for employers to include noncompete provisions in employment contracts.

Florida — H0485/S0942 would have invalidated restrictive covenants for physicians that attempt to prevent them from practicing medicine within a specific geographic area for any period of time after the termination of a professional relationship, making these geographical restrictions void and unenforceable.

Idaho — H0486 would have established that most non-compete agreements are void and unenforceable. The bill had exceptions for when a business is sold, when business partners agree not to compete and for employees annually earning $250,000.

Indiana — HB1625 would have prevented anyone from entering into new noncompete agreements after July 1, 2025, but existing agreements would have remained valid.

Kentucky — SB234 would have made noncompete clauses unenforceable for anyone except senior executives (defined as anyone making more than $151,164 annually in a policy-making position). Exceptions to the ban include clauses related to business sales.

Maryland — HB1288/SB658 would have created new restrictions on noncompete and conflict of interest clauses. These clauses would be null and void for most workers, but for healthcare workers earning more than $350,000 annually they could still be permitted with limitations. Limitations included they can’t last more than one year and can’t restrict employment beyond 10 miles. Employers would also have been required to give information about the healthcare worker’s new practice upon patient request.

Missouri — HB913/SB383 would have stated that noncompete clauses for physicians would only be valid in limited circumstances, based on time and distance. The bill would have exempted agreements between physicians and research university hospitals from these restrictions.

Missouri — HB448 would have prohibited noncompete clauses for physicians. While the noncompete clauses would be rendered invalid, the bill stresses that the rest of any existing employment contracts would remain intact.

Mississippi — HB806 would have made unenforceable any contract provision that restricts a healthcare provider’s ability to practice their profession in any area for any period of time after ending their relationship. The bill would only have applied to contracts created or renewed after July 1, 2025, and the rest of the contract would be valid after noncompete provisions were struck.

Nevada — SB378 – Among other things, the bill would have prohibited noncompete agreements for patient-facing healthcare providers.

Oregon — HB3227 would have voided most noncompetition, nondisclosure, nondisparagement, and nonsolicitation terms for medical professionals, with exceptions including agreements made during the sale of a professional medical entity where the medical professional owns at least 10% of the entity, or agreements when the professional has an ownership interest. Retaliatory disciplinary actions would be considered an unlawful employment practice. The bill would have applied to contracts entered into or renewed on or after its effective date.

Oregon — SB957 would have restricted noncompetition agreements for healthcare providers, voiding them with the exception where they involve a business entity where the provider has at least a five percent ownership interest and provides direct patient care services. The bill would have applied retroactively, making all noncompete agreements subject to the ban.

Texas — HB4067 would have prohibited most non-compete agreements.

Hawaii — HB1490/SB1179 establishes a universal, single-payer health care system to provide comprehensive health coverage for all residents of Hawaii. The system would allow residents to maintain supplemental health insurance if desired.

Illinois — HB3287 would create the Illinois Medicare for All Health Care Act, providing comprehensive health coverage to all state residents. Funding would come from a progressive contribution model, supplemented by federal healthcare funds, grants, and other designated revenues. Only non-profit healthcare providers would be able to participate, and private insurers would be prohibited from offering duplicate coverage.

Illinois — HB3568 establishes the Health Care for All Illinois Act, a comprehensive universal healthcare program to provide health insurance to all state residents. Funding would come from a progressive contribution model, supplemented by federal healthcare funds, grants, and other designated revenues. Only non-profit healthcare providers would be able to participate, and private insurers would be prohibited from offering duplicate coverage.

Illinois — HB3780 creates the Illinois Universal Health Care Act, establishing a comprehensive, state-wide health insurance program to cover all state residents, funded through government appropriations, progressive income contributions, and federal healthcare funds. Only non-profit healthcare providers would be able to participate, and private insurers would be prohibited from offering duplicate coverage.

New York — A06273 establishes the New York State Public Health Care Option Program to offer competitive, affordable health insurance with access to quality providers, and will be available through the state’s health insurance Marketplace. The program would be funded through member premiums, potential federal payments, and other state funds.

New York — S03425 would create the New York Health program to provide universal health coverage for all New York state residents without premiums, deductibles, or co-pays funded through payroll and non-payroll income taxes.

Ohio — SB78 would create a single, comprehensive universal healthcare system for all residents in Ohio, funded through federal funding, payroll taxes, and other new taxes.

Washington — HB1445/SB5233 would create the Washington Health Trust to provide universal health coverage to all state residents via a comprehensive healthcare system. Funding would come from new capital gains taxes and employer contributions, guaranteeing coverage without premiums, deductibles or copayments.

Oregon — SB951 prevents management service organizations from controlling a majority of medical practice shares, or controlling any clinical decision-making. The bill also makes nondisclosure, and nondisparagement agreements viod and unenforceable for medical professionals.

California — SB351 prohibits private equity groups from interfering with healthcare clinical decision making, but also prevents the investment groups from exercising control over non-clinical aspects, including staffing, relationships with payers, and billing decisions. The bill includes invalidating healthcare provider noncompete and nondisclosure clauses.

Illinois — SB1998 would require healthcare facilities or provider organizations to notify the AG at least 30 days before any mergers or new affiliations. The bill adds that the AG must provide written consent if a private equity group is providing financing for the transaction. The AG would be given power to investigate the transaction.

Minnesota — SF3354 would prevent private equity companies from acquiring (or increasing) their ownership or control over healthcare providers. Exceptions allow for routine replacement of employees or directors as part of normal business.

New York — S08442 requires that the majority of control in a medical professional corporation be licensed New York physicians. Non-physician entities are prevented from controlling medical practices, but has exceptions for some specific types of organizations, including rural health clinics and nonprofits serving underserved populations.

Vermont — H0071 prevents corporations from interfering with the clinical judgement of medical professionals, and prevents non-medical entities from controlling medical practices. It also requires healthcare entities to inform the state before any material change transaction (mergers, acquisitions or partnerships) of over $1 million or more. The bill would also require physicians to have majority ownership and control of medical practices, and would void any non-competition and non-disclosure agreements that could restrict rights.

Washington — HB1675 would prevent organizations and people without a medical license from interfering with providers’ professional decisions, such as treatments, coding and referrals. Any professional service corporation running a practice must have a majority of voting shares and directors be licensed providers.

Washington — SB5387 would prohibit anyone (including corporations) without a healthcare license from owning a healthcare practice and employing licensed providers. Any professional service corporation running a practice must have a majority of voting shares and directors be licensed providers. Non-licensed providers would be prevented from interfering in clinical decision-making in many settings. There are exemptions to these rules.

Connecticut — HB06570 would have prevented private equity firms from owning or controlling healthcare facilities or practices. It would also have required existing practices and facilities to disclose their current ownership and report significant changes, and would give the AG power to ensure compliance.

Connecticut — SB00469 would have restricted private equity groups from acquiring hospitals, prevented hospitals from engaging in real estate investment trust transactions, and would have required medical groups and ASCs to be primarily owned and controlled by physicians.

Connecticut — SB01480 would have required any hospital or nursing home receiving Medicaid reimbursement to be free of private equity ownership interests.

Connecticut — SB01507 would have prevented prevent private equity companies from acquiring hospitals and health systems, and from exercising control over these facilities. Restrictions would be added to prevent interference with healthcare providers’ professional decision making, and any nondisclosure agreements that attempt to circumvent these protections would be invalidated.

Indiana — SB0243 would have required that a majority of the ownership of a physician group practice be physicians licensed to practice in Indiana.

New Mexico — SB450 would have created the “Corporate Practice of Medicine Act” and would have prohibited interference with clinical decision making, but would not have applied to federally qualified health centers or independent healthcare practices owned entirely by individual healthcare providers.

Arkansas — HB1426 amends existing law to expand the definition of “healthcare insurer” to include third-party administrators and other entities acting on behalf of self-insured health benefit plans. The bill also bans all-product clauses, and prevents enforcement of any clauses with the same effect. Additionally, the bill modifies rules around leasing or sharing healthcare contracts and provider networks to require more transparency and to give healthcare providers the ability to decline participation in these arrangements.

Indiana — SB0003 legally imposes fiduciary duties for TPAs and PBMs when employed by health plans, requiring them to act in the best interest of the plan sponor, and ensure transparency with their contractual arrangements.

Texas — HB3508/SB1151 modifies the Texas Insurance Code so that insurers must conduct a review of a TPA’s operations at least semiannually and perform an audit of those operations at least every two years, when a TPA manages benefits for more than 100 insured.

California — AB489 would prevent AI from using any terms that imply that the AI’s advice and assessments are coming from a licensed healthcare professional, expanding existing laws that prevent people from falsely claiming they are licensed professionals.

Louisiana — HB114 would have prevented healthcare providers from using AI to make diagnostic and treatment decisions without review, and would prevent providers from using AI to directly interact with patients when addressing treatment or recommendations. AI could be used for administrative and analytical tasks.

Rhode Island — H5172 would have required health insurers to publicly disclose how they use AI to manage coverage and claims. The bill would require any decisions to deny or reduce coverage generated by AI be reviewed by a qualified healthcare professional who could reverse the AI’s decisions.

No new entries in this category.