The bill adds a new section to South Dakota’s chapter 34-22 prohibiting employers, educational institutions, state agencies, political subdivisions, and other persons from requiring an individual to receive a COVID-19 vaccination as a condition of employment, enrollment, or receiving a benefit or service. A violation is classified as a Class 2 misdemeanor.

FULL SUMMARY

The bill adds Chapter 9 to Pennsylvania Title 12, establishing notification requirements for mergers, acquisitions, and contracting affiliations involving manufacturers or distributors of fire trucks, ambulances, and emergency-service vehicles. A person doing business in Pennsylvania that must file a federal premerger notification under 15 U.S.C. § 18a must provide the complete filing to the Pennsylvania Attorney General at the same time it is submitted to federal authorities. Parties to a covered material change must also notify the Attorney General in writing at least 120 days before the transaction’s effective date. Covered transactions include specified mergers, acquisitions, and contracting affiliations; an out-of-state party is covered when it generates at least $5 million in Pennsylvania service or sales revenue. Notices must identify the parties and addresses, relevant service locations and suppliers, the transaction’s nature and purpose, and anticipated effective date. The Attorney General must request any additional information within 30 days, and noncompliance is subject to a civil penalty of up to $500 per day; failure to comply does not create a private cause of action.

The chapter authorizes the Attorney General to investigate suspected violations of the chapter and enforceable federal antitrust laws, including by administering oaths, issuing subpoenas, requiring written interrogatory responses, collecting evidence, and seeking Commonwealth Court orders compelling compliance. Parties may petition to modify or set aside a subpoena or interrogatory within five business days after service or before its return date. Concealing, destroying, falsifying, or withholding requested information, or otherwise evading an investigation, may result in a civil penalty of up to $25,000, plus attorney fees and costs where applicable. Investigative materials and qualifying information obtained from other agencies are subject to confidentiality and Right-to-Know Law protections.

The bill authorizes private plaintiffs injured in business or property to recover either treble damages or the full overcharge or underpayment, including where the plaintiff dealt indirectly with the defendant; proof of individual reliance is not required, and class actions are permitted. The Attorney General may coordinate enforcement and share information with federal, state, and other state agencies. The chapter applies to Attorney General actions pending on or after the effective date; the provision governing that application and the effective-date section take effect immediately, while the remainder takes effect in 60 days.

FULL SUMMARY

The legislation revises the covered-transaction framework for Pennsylvania health care entities. It narrows “health care entity” to persons controlling hospitals or hospices and expands “covered entity” to include out-of-state entities, hedge funds and their affiliates, as well as for-profit and investment entities. The definition of a covered transaction expressly includes leasebacks and excludes certain business-improvement loans, clinical affiliations, intellectual-property transactions and ordinary-course operational contracts. The threshold for a “material amount” increases from $10 million to $25 million, with annual inflation adjustments beginning January 1, 2028.

Before consummating a covered transaction, the covered entity must file a notification with the Attorney General and either complete a 60-day review period or obtain a written notice of no objection. The filing must include expanded information, including federal merger filings, recent closures or substantial service reductions by related health care entities, and sale-leaseback, mortgage, lease and other real-estate documents. The Attorney General may request additional information, extend review for 30 days, and seek further court-ordered extensions. Public hearings may include written testimony from employees, residents, patients, caregivers, providers and advocacy organizations, and must be livestreamed and recorded if held.

The Attorney General must issue a written notice regarding whether the transaction is likely to be against the public interest and, after consulting the Department of Health, may seek an injunction or enter an assurance of voluntary compliance. Assurances may impose conditions and provide for monitoring for up to five years, with one additional extension of up to five years; the covered entity must pay monitoring and review costs, may seek a hardship waiver, and may not pass merger or acquisition review costs to the health care entity. The Department’s role is limited primarily to cooperative compliance monitoring, while confidential review materials receive expanded protection. A legislative study on the chapter and private equity’s effects on the health care system is required within three years, and the act takes effect in 180 days.

FULL SUMMARY

Effective January 1, 2027, the bill removes provisions that would have made changes to the Illinois Health Facilities Planning Act’s ownership-exemption rules inoperative and repealed the Antitrust Enforcement Fund and related Illinois Antitrust Act provisions. The fund therefore remains in operation, and penalties under the Antitrust Act continue to be deposited into it.

The bill revises health-care transaction notice requirements to apply to covered transactions involving health care facilities, provider organizations, and entities that directly or indirectly own or control them, including transactions involving private equity companies. Covered transactions involving an Illinois entity and an out-of-state entity require notice when the out-of-state entity generates at least $10 million in annual revenue from Illinois patients. The bill also clarifies that notice is due at least 30 days before closing or the transaction’s effective date, and permits compliance through specified federal premerger filings or, for covered facility ownership changes, the required Health Facilities and Services Review Board filing.

For transactions not covered by those filing alternatives, the notice must identify the involved facilities, provider organizations, and parties with their current business addresses; list the locations where each disclosed entity currently provides health care services; describe the transaction’s nature and purpose; and state its anticipated effective date. The Attorney General may request relevant additional information within 30 days after receiving notice, delaying the transaction until 30 days after substantial compliance; violations remain subject to civil penalties of up to $500 per day, injunctive relief, and a 10-day opportunity to cure before enforcement, except that no cure period applies on or after the earlier of the proposed or actual closing date.

The Secretary of Health and Human Resources must convene a work group to study private equity’s impact on health care. The work group must assess current health care facility ownership-transparency requirements in Virginia and compare them with requirements in other states and at the federal level; identify public risks and benefits of greater ownership transparency; assess risks and benefits associated with private-equity acquisitions of health care facilities; and develop policy recommendations to increase ownership transparency in Virginia.

The work group must include relevant stakeholders, including representatives of the Virginia Association of Health Plans, Virginia Hospital and Healthcare Association, Medical Society of Virginia, and Virginia Health Care Association, along with other stakeholders the Secretary considers appropriate. The Secretary must report the group’s findings and recommendations to the chairs of the House Committee on Health and Human Services and the Senate Committee on Education and Health by November 1, 2026.

The bill inserts RSA 328-D:20, making restrictions in contracts or agreements involving a physician associate licensed by the board of medicine unenforceable. This includes restrictions on the physician associate’s right to practice in any geographic area for any period after termination of a partnership, employment, or other professional relationship. The remaining contract provisions remain enforceable.

The requirement applies only to new contracts and contract renewals entered into on or after the effective date. The act takes effect July 7, 2026.

FULL SUMMARY

The bill adds Labor Law § 191-d to prohibit employers and their agents from seeking, requiring, demanding, or accepting post-employment non-compete agreements from covered individuals or specified health-related professionals. A covered individual is a worker economically dependent on and obligated to perform duties for another person, excluding a highly compensated individual whose average annualized cash compensation is at least $500,000 based on recent W-2 and, where applicable, K-1 statements; that threshold will be adjusted annually beginning in 2027 using the New York Consumer Price Index. Covered health-related professionals include specified licensed physicians, assistants, chiropractors, dentists, veterinarians, therapists, pharmacists, nurses, podiatrists, optometrists, psychologists, speech and audiology professionals, and mental health practitioners.

Any prohibited non-compete agreement entered into after the effective date is void and unenforceable. A covered individual or health-related professional may sue within two years of the latest of signing, learning of the agreement, termination of the employment or contractual relationship, or an employer’s enforcement step. Courts may void the agreement and order injunctive relief, lost compensation, compensatory damages, attorney’s fees and costs, and liquidated damages of up to $10,000, with liquidated damages required for each affected individual. The bill preserves agreements establishing fixed service terms or employment exclusivity, protecting trade secrets or confidential client information, or restricting client solicitation, provided they do not otherwise unlawfully restrict competition.

Non-competes remain permissible in connection with the sale of business goodwill or disposition of a business ownership interest when the seller owns at least 15 percent. Such agreements must satisfy New York common-law enforceability requirements, may not restrict competition for more than one year, and must provide salary during the enforcement period. Choice-of-law and venue provisions cannot evade these protections for individuals residing or working in New York for at least 30 days before cessation of employment, including certain remote workers reporting to a New York workplace or supervisor. The bill also adds Labor Law § 45, directing the Department of Labor to develop and publish an employee notice and requiring employers to post it; the main provisions apply 30 days after enactment to contracts entered into or modified thereafter, without retroactive effect, while the notice provision takes effect 180 days after enactment.

FULL SUMMARY

Effective July 1, 2026, the act establishes 18 V.S.A. chapter 233 governing clinical decision making and ownership transparency in specified health care entities. It defines health care facilities, providers, services, staffing companies, management services organizations, private equity groups, hedge funds, ownership or investment interests, provider organizations, and significant equity investors. Private equity groups and hedge funds involved with Vermont health care facilities may not interfere with providers’ clinical judgment, including decisions on diagnostic testing, referrals, treatment plans, patient volume, or work hours. They also may not control or receive delegated authority over clinical standards or staffing levels, medical-record content, clinically based hiring or firing, payer-contracting parameters, service prices, clinical competency requirements for provider contracts, coding and billing decisions, or medical-equipment and supply selection. Agreements that enable such interference or control are prohibited, regardless of the facility’s organizational form. Nonclinical management, administrative, business, assistance, and consulting services remain permitted when a licensed provider retains ultimate responsibility or approval and the services do not constitute de facto control affecting clinical decisions or service quality. Aggrieved providers may seek equitable relief, actual damages, costs, and attorney’s fees in Superior Court.

Beginning March 1, 2027, each covered health care facility and management services organization must report to the Green Mountain Care Board whether it had private-equity or hedge-fund ownership or investment as of June 1, 2026. Entities with such interests must disclose the names, business addresses, and business identification numbers of persons with ownership, control, management-services, or significant-equity interests; a current organizational chart showing affiliates and subsidiaries; and the most recent fiscal year’s profit-and-loss statement and balance sheet. After the initial deadline, updated reporting is required when a previously unreported private equity group or hedge fund acquires an interest or when an existing interest changes. Nursing homes, health care staffing companies, federally qualified health centers, and entities providing Vermont services exclusively through telehealth or remote patient monitoring are exempt. Reported information is generally public, while individual providers’ Social Security-linked taxpayer IDs and contact information and submitted financial statements are confidential, subject to specified sharing with the Office of the Health Care Advocate and government officials. Knowing failure to report carries a civil penalty of up to $50 per day, capped at $10,000 per year; material misrepresentations carry penalties of up to $25,000 each, enforceable by the Attorney General.

By July 1, 2027, and every two years thereafter, the Board must publish a website report summarizing covered reporting, ownership and control entities, ownership changes, tax-identification-number changes, and applicable affiliates, subsidiaries, and management-services entities. The Board may share information with specified state officials and agencies for oversight, enforcement, or to reduce duplicative reporting, while preserving confidentiality requirements.

FULL SUMMARY

Establishes Iowa Code chapter 135S defining “conscience,” “discrimination,” “health care institution,” “health care service,” “medical practitioner,” and participation in a health care service. Medical practitioners and health care institutions may decline to participate in or pay for a health care service that violates their conscience, provided practitioners inform their employers of the nature of the objection; they may not face discrimination for doing so. The provision does not relieve institutions of federal emergency-treatment obligations under 42 U.S.C. §1395dd. Religion-based institutions meeting specified public-facing, governing-document, and policy criteria may make employment, staffing, contracting, and admitting-privilege decisions consistent with their religious beliefs.

Provides civil, criminal, and administrative immunity for good-faith exercise of conscience, including institutional immunity for covered practitioners’ conduct. Prohibits discrimination against practitioners or institutions for reporting suspected violations, testifying, or participating in proceedings, and protects disclosures concerning legal or regulatory violations, breaches of care or ethical standards, gross mismanagement or waste, abuse of authority, patient-health risks, or substantial and specific threats to public health or safety. These protections do not override HIPAA or other confidentiality and privacy requirements.

Restricts health agencies and licensing or certifying entities from sanctioning, threatening, or revoking a license or certification based on constitutionally protected speech, expressive activity, or association unless clear and convincing evidence shows it directly caused physical harm to a patient or client with whom the practitioner or institution had a professional relationship within the prior three years. Covered complaints that could lead to revocation must be provided within 21 days; noncompliance incurs a $500 administrative penalty for each day. The state may not contract with or require credentials from entities that revoke or deny credentials to compliant practitioners or institutions that did not provide medical advice or treatment. Unlawful interference with conscience, whistleblower, or free-speech rights is actionable through injunctions, damages, and attorney fees; the law also bars civil suits against persons who decline to use or purchase services because of a covered exercise of conscience.

The bill adds a new provision to Tennessee Code Annotated, Title 50, declaring void and unenforceable any restriction on an employee’s or contractor’s right to practice their profession after termination or conclusion of the employment or contractual relationship, except as provided in § 63-6-204(f)(2).

It deletes § 63-1-148 and removes references to that section or its successor from §§ 63-6-204(f)(2)(B), 63-6-204(g)(2)-(3), and 68-11-205(c)(2)-(3) and (f)(2). The changes also replace language making certain provisions operate “notwithstanding” § 63-1-148 with language stating that they apply directly, and delete a requirement that a restriction comply with § 63-1-148.

The act takes effect July 1, 2025, and applies to contracts entered into or amended on or after that date.

The bill adds a Tennessee Code provision declaring void and unenforceable any restriction on an employee’s or contractor’s right to practice the person’s profession after termination or conclusion of the employment or contract, except as otherwise provided in Tennessee Code Annotated § 63-6-204(f)(2).

It repeals § 63-1-148 and removes references to that section or its successor from specified provisions governing physicians and healthcare facilities, including §§ 63-6-204(f)(2)(B), 63-6-204(g)(2)-(3), and 68-11-205(c)(2)-(3) and (f)(2). The related language is revised so those provisions no longer state that restrictions are permitted under § 63-1-148 or require compliance with that section.

The changes take effect July 1, 2025, and apply to contracts entered into or amended on or after that date.

FULL SUMMARY

The law expands Virginia’s prohibition on covenants not to compete to cover health care professionals—persons licensed, registered, or certified by the Boards of Medicine, Nursing, Counseling, Optometry, Psychology, or Social Work. Employers may not enter into, enforce, or threaten to enforce such covenants against a health care professional. The bill also clarifies that an employee whose earnings derive wholly or predominantly from sales commissions, incentives, or bonuses is excluded from the definition of “low-wage employee.”

Health care professionals may sue an employer or other person attempting to enforce an unlawful covenant within two years of the latest of specified triggering events. Courts may void the covenant and award appropriate relief, including injunctions, liquidated damages, lost compensation, damages, costs, and attorney fees; employers may not retaliate against a person for bringing such an action. An employer violation determined by the Commissioner is subject to a $10,000 civil penalty for each violation.

The prohibition does not restrict reasonable covenants involving a health care professional or the professional’s business entity when included in the sale of all or substantially all specified business assets, goodwill, or ownership interests. Employers may also require departing health care professionals employed fewer than five years to repay all or a prorated share of recruitment-related, relocation, bonus, recruiting, education, or training costs, and may enforce narrowly limited customer nonsolicitation provisions covering customers or actively sought prospective customers with whom the professional had material contact and products or services the same as or substantially similar to the employer’s. Such provisions may not prevent required patient communications about the professional’s continuing practice, new contact information, or patients’ right to choose a provider. Contracts, covenants, or agreements entered into or renewed before July 1, 2026, are not invalidated or otherwise affected.

FULL SUMMARY

The act establishes the Rural Health Antitrust Immunity Act to authorize regulated collaboration among rural healthcare providers and related entities under active state supervision. Approved participants may share data and services and engage in joint purchasing, contracting, staffing, quality initiatives, technology, service-line development, facilities, equipment, infrastructure, and negotiations with payors, suppliers, and vendors. Joint negotiations involving specified health benefit plans, health insurers, employee welfare benefit plans, certain governmental healthcare plans, or their administrators are expressly excluded from approval.

Before conducting covered activities, an entity or individual must obtain a certificate from the State Health Planning and Development Agency. Applications must identify the parties, describe the activities, assess anticipated effects including competition impacts, provide requested information, and certify good-faith participation and reasonable necessity to advance the act’s rural healthcare policy. The agency may approve activities only when they are reasonably necessary and their benefits outweigh foreseeable anticompetitive effects, considering factors including rural care quality and access, facility availability, resource efficiency, health outcomes, underserved populations, payor negotiations, competition, service quality and prices, and less-anticompetitive alternatives. Certificates do not take effect until written approval by the Governor or designee, who may approve, partially approve, reject, return, or condition them.

Certificates are valid for three years and may be renewed in three-year increments upon specified certifications and explanations. The agency must adopt rules for ongoing active supervision and implementation and must amend or revoke a certificate at any time if the activities cease to be reasonably necessary or their benefits no longer outweigh foreseeable anticompetitive effects. Conduct carried out under an approved and supervised certificate is intended to receive exemption from state antitrust laws and limited federal antitrust immunity under the state-action doctrine. The act takes effect immediately.

FULL SUMMARY

The bill adds Labor Law § 191-d to prohibit employers and their agents from seeking, requiring, demanding, or accepting non-compete agreements from covered health-related professionals, including physicians, physician assistants, chiropractors, dentists, veterinarians, pharmacists, nurses, therapists, psychologists, and specified other licensed medical professionals. Covered restrictions include clauses barring practice with a new employer; financial penalties, repayment, or reimbursement obligations tied primarily to changing employers after work for a hospital or related entity; requirements to obtain employer consent or submit to equitable relief; and indirect restrictions that limit or deter practice with a new employer. Nondisclosure agreements protecting confidential information or trade secrets are excluded.

Any prohibited agreement entered into after the effective date is void and unenforceable. A covered professional may sue within two years of the latest of signing, learning of the agreement, termination of employment or the contractual relationship, or an enforcement step. Courts may void the agreement and award injunctive relief, liquidated damages of up to $10,000 per affected professional, lost compensation, compensatory damages, attorney’s fees, and costs; liquidated damages are mandatory for each affected professional.

The prohibition preserves agreements establishing fixed service terms or exclusivity during employment and agreements protecting trade secrets or confidential or proprietary client information. It does not affect Labor Law § 202-k and does not bar non-compete or similar covenants connected to the sale of business goodwill or a majority ownership interest when the seller owns at least 15 percent. Permissible covenants must satisfy New York common-law enforceability standards, may not restrict activity for more than one year, and must provide salary during enforcement. Choice-of-law or venue provisions cannot circumvent the requirements for professionals who lived or worked in New York for at least the preceding 30 days, including certain remote workers reporting to New York.

The bill also adds Labor Law § 45, directing the Department of Labor to develop and publish a notice describing these protections and rights; employers must post it conspicuously in workplaces and locations frequented by employees and applicants. The restrictions apply to contracts entered into or modified beginning 30 days after enactment and have no retroactive effect; the notice provision takes effect 180 days after enactment.

FULL SUMMARY

The bill amends Massachusetts law to require the Office of Patient Protection to assist consumers with questions about electronic health information accessibility requirements and to record and submit reported violations to the Executive Office of Health and Human Services, the Attorney General, and the federal Office of the National Coordinator for Health Information Technology.

It requires all Massachusetts health care providers to comply with applicable 21st Century Cures Act requirements, including interoperability, patient access through application programming interfaces, and prohibitions on information blocking. The Executive Office of Health and Human Services, in consultation with the relevant commission, must develop a standardized written or electronic patient notification explaining rights and obligations concerning electronic health information and how to report access violations. The office must also promulgate regulations requiring patients’ express written consent before third-party application programming interfaces collect, capture, purchase, or transfer electronic health information, and prohibiting those applications from disclosing, redisclosing, disseminating, selling, leasing, trading, or otherwise profiting from such information except to provide the patient direct data access with consent.

Violations are subject to existing chapter 118I fines and constitute unfair or deceptive acts under chapter 93A. For violations involving patient access to electronic health information reported by the Office of Patient Protection, the fine may not be less than $1,000 per day per violation. The act takes effect immediately upon passage.

FULL SUMMARY

The Act establishes a Maine Department of Health and Human Services review process for material change transactions involving health care entities and private equity companies, hedge funds, or related management services organizations. A covered transaction is an acquisition of a majority interest or operational control of a Maine health care entity in one transaction or related transactions. The health care entity must file notice with the department at least 180 days before completion, including the parties, transaction agreements and terms, objectives, effects on services, affected geographic areas and populations, and services that may be added, reduced, or eliminated. Notice information is generally public, subject to protection for approved proprietary information, and the department must publish a public summary within 10 days.

Within 60 days after a complete notice, the department, consulting with the Office of Affordable Health Care, must approve the transaction without comprehensive review, approve it subject to conditions, or require comprehensive review. Comprehensive review is mandatory for transactions transferring assets valued above $100 million, lessening competition, or likely to materially affect health care cost, quality, equity, or access. The review includes public hearings, an optional Office of Affordable Health Care analysis of cost and market effects, requests for additional information, and a public report; the department may approve, conditionally approve, or disapprove the transaction, and completion is barred until the department issues its determination. The department may charge filing fees set by rule, with initial fees between $2,000 and $10,000, and recover reasonable review and monitoring costs.

The Act authorizes post-transaction audits and enforcement, including Attorney General subpoenas and equitable remedies, department audits, and administrative penalties of $10,000 per day for violations. Entities subject to approval following comprehensive review must submit compliance, cost, access, workforce, quality, and equity reports one, two, and five years after completion and at later intervals set by the department. It also requires health care entities to report ownership and control information to the designated organization by July 1, 2027, and after each covered transaction, including organizational structures, affiliates, subsidiaries, identifiers, and specified hospital-provider and facility information. Most reported information must be made public through annual reports beginning January 1, 2029, while individual Social Security-based taxpayer identifiers and specified business identifiers remain confidential. Small independent provider organizations with six or fewer providers receive specified exemptions. The Act takes effect January 1, 2027.

FULL SUMMARY

The bill makes a covenant not to compete unenforceable when an employer discharges an employee without cause and without providing severance benefits or another monetary payment. The severance or payment must be disclosed when the covenant is executed.

It expands the private right of action beyond low-wage employees: any employee may sue a former employer or other person attempting to enforce an unlawful covenant. The action must be filed within two years of the latest of the covenant’s signing, the employee’s learning of it, termination of employment, or an enforcement step. Courts may void the covenant and award appropriate relief, including injunctive relief, liquidated damages, lost compensation, damages, and reasonable attorney fees and costs. Employers may not discharge, threaten, discriminate against, or retaliate against an employee for bringing such an action.

Employers that violate the prohibition on covenants with low-wage employees or the new discharge-and-severance condition are subject to a $10,000 civil penalty for each violation, as determined by the Commissioner. Contracts, covenants, or agreements entered into, amended, or renewed before July 1, 2026, are not invalidated or otherwise affected.

FULL SUMMARY

The bill adds the Rhode Island Ban on the Corporate Practice of Medicine Act. It generally prohibits unlicensed individuals and entities from owning medical practices, employing healthcare licensees, or practicing medicine, and bars them from interfering with licensees’ professional judgment or clinical decisions. Physician practices may employ physicians only if Rhode Island-licensed physicians hold a majority of each voting share class and constitute a majority of directors, with nearly all officers also required to be licensed. Exceptions permit specified safety-net and public providers, hospitals, health and hospital districts, school-based clinics, and tribal clinics to employ physicians.

The bill regulates medical-practice relationships with management services organizations. It requires meaningful ownership by licensed owners who are present in Rhode Island and substantially engaged in care or management; restricts dual ownership, management, employment, contracting, and compensation arrangements between practice leaders and management organizations, subject to an exception when the practice owns a majority interest in the management organization; and prohibits transferring control over shares, assets, dividends, or stock issuance. It generally invalidates licensee noncompetition agreements, except where the licensee owns or controls at least 25% of the other party, and invalidates nondisclosure and nondisparagement agreements with management organizations, employers, or other entities, while preserving claims for independent torts. Management organizations and other non-practice entities may not advertise a practice’s services under their own name or assume de facto control over administrative, business, or clinical matters affecting care; prohibited control includes decisions concerning licensed staff, revenue, hospital negotiations, staffing, visit times, coding, clinical policies, billing, prices, and payor contracts. Delegation to a management organization is allowed only when authorized exclusively by a majority of licensed-owner shareholders and it does not transfer de facto control.

The bill creates enforcement mechanisms, including attorney general subpoenas, damages, injunctive and equitable relief, attorneys’ fees and costs, and statutory penalties of $10,000 per day; Department of Health administrative penalties of $10,000 per day and authority to disapprove violating transactions or agreements; and a private action without exhaustion of administrative remedies, with potential statutory damages of up to $100,000 per plaintiff per intentional violation. It also creates healthcare-ownership transparency requirements beginning January 1, 2027: healthcare entities must report ownership, control, affiliates, organizational structure, providers, facilities, governing-board compensation, and comprehensive financial information annually and after covered material-change transactions. The Department of Health must publish annual public reports, conduct random audits, adopt implementing rules, and may assess fees; individual provider taxpayer identification numbers that are Social Security numbers remain confidential. Reporting penalties are capped at $50,000 per report for smaller independent entities meeting specified physician or revenue thresholds and $500,000 for other entities. The bill takes effect upon passage.

FULL SUMMARY

Effective October 1, 2026, the bill establishes statewide limits on covenants not to compete and exclusivity agreements entered into, amended, extended, or renewed on or after that date. A noncompete is void against an employee earning less than twice the minimum fair wage or an independent contractor earning less than five times the minimum fair wage. It is also unenforceable to the extent it covers geographic areas where the worker had no services, material presence, or influence during the preceding two years, or work the worker did not perform during that period. Nonsolicitation, confidentiality, certain statutory noncompetes, no-rehire provisions, and agreements tied to a business sale or partnership or ownership arrangement are excluded. For wage-threshold purposes, compensation for nonhourly workers is annualized and divided by 2,080 hours.

A qualifying noncompete may be enforced only against an employee or contractor meeting the applicable wage threshold and only if it lasts no more than one year, or up to two years when the worker receives base salary and benefits throughout the restriction. It must protect a legitimate business interest that cannot reasonably be protected by less restrictive means and must be no broader than necessary in duration, geographic scope, type of work, or type of employer; the worker must be an exempt employee. Additional requirements include advance delivery of the agreement and specified worker-rights notice at least five business days before the earlier of the acceptance deadline or signing, separate execution, sufficient consideration for later-added restrictions, no termination by the worker for employer-attributable good cause, no out-of-state adjudication requirement, and compliance with state law. Employers and contractors generally may not require exclusivity agreements unless the worker exceeds the applicable wage threshold or outside work would threaten safety or substantially interfere with reasonable scheduling; on-call scheduling is excluded from that scheduling protection, and existing loyalty and conflict-of-interest duties remain unchanged.

Courts may not modify a noncompete or exclusivity agreement that violates these requirements to make it enforceable, although unrelated severable provisions remain effective. The enforcing party bears the burden of proof, as does the party seeking to stop compensation promised for the restriction’s duration. Aggrieved workers may sue in Superior Court for damages, equitable or injunctive relief, costs, and attorney’s fees, with civil penalties of up to $5,000 available against a violator. The Attorney General may investigate patterns of violations, use subpoenas and interrogatories, bring state civil actions, seek relief and penalties of up to $5,000 per defendant, distribute awarded damages to injured workers, or accept assurances of discontinuance; investigation materials may not be used in criminal proceedings. The bill also limits the existing security-guard restriction in General Statutes § 31-50a to agreements entered into, renewed, or extended from October 1, 2007, through September 30, 2026.

FULL SUMMARY

The bill creates the Global Hospital Budget Authority Act and establishes the Global Hospital Budget Authority within the Department of Public Health, governed by a Global Hospital Budget Board. The Board would select participating hospitals, negotiate and administer prospective global budgets with participating insurers, government programs, and Medicaid managed-care organizations, approve hospital transformation plans, monitor quality and population-health outcomes, require corrective action, and terminate participation under applicable agreements. It may collect and analyze data, seek state and federal waivers, provide technical assistance, and contract for independent evaluations. The bill also creates the Global Hospital Budget Fund as a separate State Treasury fund and restricts use of Authority data, contracts, and agreements through confidentiality, nondisclosure, and limited-retention requirements.

The bill changes hospital licensing requirements by requiring the Department to recognize, when patient safety and continuity of care are maintained, on-site clinicians, qualifying affiliation agreements, documented telemedicine, or rural/critical-access waivers as alternatives for staffing and specialty-service presence. Hospitals must maintain transfer agreements, response-time standards, appropriate credentialing, and continuous-quality safeguards; waivers may last no more than 24 months and may be renewed. Hospital affiliates may employ physicians subject to employment, privileging, oversight, professional-autonomy, independent-review, and physician-collaboration safeguards, with specialty presence also satisfiable through telemedicine, affiliations, shared staffing, or approved waivers. The Department must adopt implementing rules and publish model affiliation and telemedicine templates.

The bill adds heightened Health Facilities Planning Act requirements for covered transactions, including acquisitions or ownership, management, or governance changes transferring control. Applications must disclose ultimate beneficial ownership and private-equity involvement, transaction and ancillary agreements, five years of audited and pro forma financial statements, sources and uses of funds, anticipated service reductions and mitigation, an independent Community Health Impact Assessment, and post-transaction monitoring, community-benefit, and employee-transition plans. The Health Facilities and Services Review Board must complete its review before approval; private-equity or non-operating financial investors bear the burden of proving that the transaction will not materially impair essential-service access, quality, or community health. The Board may approve with conditions or deny transactions, impose at least three years of service, staffing, investment, charity-care, dividend, or recapitalization requirements, monitor compliance for at least five years, and impose penalties, restore services, or order divestiture for material violations.

For proposed facility closures or service discontinuations, the Board must require a Community Health Impact Assessment and deny the application if it would likely degrade essential outcomes, worsen geographic access to emergency or urgent care, or impose undue travel increases. Applicants must provide specified advance notices, while permit holders must report completion and the Board must monitor access, travel time, ambulance diversion, staffing, charity care, and community-health indicators for at least five years. The bill also directs the Board to disclose ownership chains in covered-transaction filings, permits enforceable conditions on discontinuations, and expands its planning and rulemaking responsibilities concerning transaction review, service reductions, and community impacts.

FULL SUMMARY

Beginning May 6, 2026, Utah prohibits a person from entering into a healthcare non-compete agreement with a healthcare worker. Any such agreement is void. “Healthcare worker” covers specified licensed healthcare professionals when their employment or contract requires practice within the scope of the license; the bill also defines healthcare non-compete and nonsolicitation agreements. Existing general non-compete agreements remain subject to the one-year post-employment limit, and the broadcasting-employee exception remains in place.

Beginning May 6, 2026, a person may not enter into a nonsolicitation agreement with a healthcare worker that prevents the worker from informing a patient of the worker’s current or future place of employment. A violating provision is void. The exceptions are revised to expressly cover healthcare non-compete agreements in qualifying severance agreements and business-sale transactions, including agreements for which the covered individual receives value related to the sale; severance agreements remain subject to common-law requirements.

Employers that seek to enforce an unenforceable general or healthcare non-compete agreement through arbitration or a civil action are liable for the employee’s arbitration costs, attorney fees, court costs, and actual damages. The bill also makes conforming terminology and definition changes in the statute governing confidentiality and non-disparagement clauses, repeals the title provision in Section 34-51-101, and takes effect May 6, 2026.

The bill amends Utah Code § 58-90-101 to define “advanced practice provider” as an advanced practice registered nurse, certified nurse midwife, or physician assistant, and to define “physician” as an individual licensed as a physician or osteopath under Utah’s medical practice statutes. It excludes physicians and advanced practice providers from the definition of “health care worker,” thereby excluding them from the health care services platform registration requirements and related restrictions that apply to platforms placing health care workers at health care facilities.

The bill takes effect May 6, 2026.

The bill adds a new section to South Dakota’s Chapter 53-9 authorizing parties to include a post-transfer non-compete provision in a business entity’s governing document or in a contract for the purchase, sale, or transfer of an ownership interest.

The provision may restrict a former owner from engaging, directly or indirectly, in the same or a similar type of business conducted by the entity during the owner’s period of ownership. Any restriction must apply within the specified geographic area in which the entity conducts business and may not extend beyond three years from the date of the ownership transfer.

FULL SUMMARY

The bill revises Utah’s non-compete law and repeals Section 34-51-101. It adds a definition of “nonexempt employee,” changes terminology to “non-compete agreement,” narrows the covered restriction to competition involving a similar product, process, or service, and expressly excludes nonsolicitation, nondisclosure, confidentiality, and training-repayment agreements. For agreements entered into on or after May 6, 2026, an employer may not enforce a non-compete against a nonexempt employee; a full- or part-time undergraduate or graduate student working in an internship or other short-term job; an employee age 18 or younger; an employee whose total earnings from the employer in the most recent calendar year were below $155,000; or an employee terminated because of a reduction in force. A person also may not enforce such an agreement against an independent contractor.

Employers intending to enter into a non-compete must include it with the employment offer, present it in a manner a reasonable person would understand, and include a statutory reference to the governing section. The employer must also provide written notice at least 14 calendar days before the earlier of the employee’s start date or the agreement’s effective date. Agreements violating the substantive restrictions are void, while agreements presented without complying with the offer and notice requirements may not be enforced. The bill preserves exceptions for reasonable severance agreements and non-competes connected to a business sale when the person subject to the restriction receives value related to the sale; severance agreements remain subject to common-law requirements.

For arbitration in which an employer seeks to enforce a non-compete that violates the chapter, the arbitrator must award arbitration costs and actual damages; the prior provision awarding attorney fees and court costs through that process is removed. An employee or independent contractor who is a party to an unlawful non-compete receives a right of action against a person seeking to enforce it, and a court finding a violation must award actual damages, injunctive relief, arbitration costs, and reasonable costs and attorney fees. The bill takes effect May 6, 2026.

FULL SUMMARY

Creates the Global Hospital Budget Authority Act and establishes the Global Hospital Budget Authority within the Illinois Department of Public Health, with its powers vested in a Global Hospital Budget Board. The Board will administer a voluntary global-budget payment model for eligible hospitals, select and support participating hospitals, approve transformation plans and prospective annual budgets, monitor quality, cost, and population-health metrics, require corrective action, and terminate participation under applicable agreements. The bill establishes Board membership and conflict-of-interest rules, authorizes contracts, grants, waivers, data collection, and technical assistance, requires annual independent audits and reports, limits data retention to seven years, restricts data use and disclosure, and creates the Global Hospital Budget Fund as a separate State Treasury fund.

Changes to the Hospital Licensing Act require the Department, when patient safety and continuity of care are maintained, to recognize on-site clinicians, qualifying affiliation agreements, documented telemedicine coverage, or specified rural or critical-access-hospital waivers as alternatives satisfying staffing and service-line presence requirements. Specialty presence may not be required when documented alternative mechanisms provide clinically equivalent timely care and safe transfers; waivers are limited to 24 months and renewable upon demonstrated need and compliance with quality and transfer metrics. Employing entities may employ physicians to practice medicine in all branches if employment, privileging, and oversight requirements are met, and specialty requirements may be satisfied through telemedicine, affiliation agreements, shared staffing, or approved waivers subject to transfer agreements, response-time standards, credentialing, and continuous-quality safeguards. The bill also adds physician-review, professional-autonomy, anti-retaliation, enforcement, and Department rulemaking provisions, and directs the Department to adopt implementing rules and publish model affiliation and telemedicine templates within six months and report on waivers within 18 months.

Changes to the Illinois Health Facilities Planning Act expand covered-transaction review and disclosure requirements for proposed acquisitions or transfers of hospital ownership or control, including transactions involving private equity or other financial investors. Applicants must disclose ownership chains and beneficial owners, transaction and ancillary agreements, five-year audited and pro forma financial information, anticipated material service reductions within three years and mitigation plans, an independent Community Health Impact Assessment, post-transaction monitoring and community-benefit commitments, and employee-transition protections. The State Board must complete its review before approval, may approve, condition, or deny a transaction, and may impose at least three years of service and staffing guarantees, capital commitments, limits on dividends or leveraged recapitalizations, charity-care requirements, and community-benefit agreements; it must monitor compliance for at least five years and may impose penalties, restore services, or order divestiture for material noncompliance. Private-equity and non-operating financial investors bear the burden of proving that a transaction will not materially impair essential-service access, care quality, or community health outcomes. For closures or service discontinuations, the bill requires a CHIA and bars approval when the change is likely to degrade essential outcomes, worsen access to emergent or urgent care, or impose undue travel burdens; it also requires post-closure monitoring for at least five years, including access, staffing, charity-care, and community-health reporting, and expands State Board authority to impose enforceable conditions and require ownership disclosures.

FULL SUMMARY

The bill establishes the Rhode Island Ban on the Corporate Practice of Medicine Act. Unless properly licensed, individuals, corporations, partnerships, and other entities may not own medical practices, employ healthcare licensees, or practice medicine, and may not directly or indirectly interfere with licensees’ professional judgment or clinical decisions. Medical practices may employ physicians only if in-state physician licensees hold a majority of each voting share class and constitute a majority of directors, with all officers other than the secretary and treasurer being licensed physicians. Exceptions allow safety-net and public healthcare providers, public hospitals, health and hospital districts, school-based health clinics, and tribal health clinics to employ physicians.

The bill regulates medical-practice relationships with management services organizations by requiring meaningful ownership by licensed owners who are present in Rhode Island and substantially engaged in care or practice management. It bars dual ownership or financial interests linking practice leadership and a contracted management organization, subject to an exception when the practice owns a majority of the management organization; prohibits transferring control over stock issuance, sale, encumbrance, or dividends; generally voids noncompetition agreements involving licensees, except where the licensee owns or controls at least 25% of the other party; and voids nondisclosure and nondisparagement agreements with management organizations or other employers, while preserving claims for tortious statements independent of a contract breach. Management organizations and other non-practice entities may not advertise a practice’s services under their own names or assume de facto control over administrative, financial, employment, staffing, coding, clinical, billing, pricing, or payer-contract decisions affecting care. Delegation to a management organization is permitted only when authorized exclusively by physician-majority shareholders and it does not transfer de facto control to non-licensees.

The bill creates protections against interference with employed or contracted licensees’ clinical judgment, including control through discipline, threats, retaliation, or pressure over patient-contact time, discharge timing, clinical status, diagnoses and coding, or available clinical orders. The attorney general may subpoena records, seek damages, injunctions, specific performance, equitable relief, and attorney fees, impose a $10,000-per-day statutory penalty, and deny or rescind approval of related material-change transactions; the Department of Health may impose the same daily administrative penalty, disapprove violating transactions, refer violations, and adopt implementing rules. Aggrieved persons may sue without exhausting administrative remedies and may receive actual damages, up to $100,000 in statutory damages per plaintiff per intentional violation, or equitable relief.

The bill also requires healthcare entities to report ownership, control, management services organizations, significant equity investors, affiliates, organizational structure, affiliated providers and facilities, governance compensation, and comprehensive financial information to the Department of Health by January 1, 2027, and annually thereafter following covered material-change transactions. Limited exemptions apply to independent organizations of two or fewer physicians without ownership or control entities, unless they undergo a material-change transaction, and to certain controlled provider organizations reported by a controlling entity; healthcare facilities are excluded from the latter exemption. The department must publish annual ownership and consolidation information, may share data for oversight while protecting individual Social Security-number-based taxpayer IDs, must conduct random audits, and may impose civil penalties up to $50,000 per deficient or false report for smaller independent entities and up to $500,000 for other entities. The act takes effect upon passage.

The bill adds a new requirement for the Iowa Board of Regents to develop a policy prohibiting the University of Iowa Hospitals and Clinics from including a noncompete clause in an employment contract with a physician. A noncompete clause is defined as a restriction on a physician’s right to practice in any geographic area or for a specified period after termination of the employment contract; “physician” means an individual licensed under Iowa Code chapter 148.

The prohibition applies to employment contracts between a physician and the University of Iowa Hospitals and Clinics that are entered into, extended, or renewed on or after the Act’s effective date. The Act takes effect upon enactment.

FULL SUMMARY

The bill establishes corporate-practice-of-medicine restrictions for medical practices organized as professional service corporations. Unless otherwise permitted, nonmedical licensees may not own a medical practice, employ licensed health care providers, or engage in medicine. Medical licensees must hold all voting shares, all director positions, and all officer positions other than secretary and treasurer, and must be substantially engaged in providing care or managing the practice. The bill restricts arrangements with management services organizations, including shared ownership or management, substantial compensation tied to ownership or management, control over transfers or issuance of practice shares or assets, dividend payments, and control over administrative, business, or clinical operations affecting clinical decisions or the nature or quality of care. Exceptions cover specified hospitals and affiliated entities, private establishments, nursing homes, ambulatory surgical facilities, birthing centers, in-home services agencies, federally qualified health centers, telemedicine-exclusive practices, health maintenance organizations, and certain integrated prepaid health care service contractors.

New provisions prohibit nonmedical persons involved with covered health care entities from interfering with, controlling, or directing the professional judgment or ultimate clinical decisions of licensed providers acting within their scope of practice. The restrictions apply across hospitals, private establishments, ambulatory surgical facilities, nursing homes, birthing centers, in-home care agencies, telemedicine-exclusive practices, health maintenance organizations, and qualifying prepaid integrated care contractors. Prohibited conduct includes using policies, discipline, threats, adverse employment actions, coercion, retaliation, or excessive pressure to control patient-care time, discharge timing, clinical status and referrals, diagnoses or coding, or available clinical orders; telemedicine practices are additionally covered with respect to providers’ ability to recommend or refer patients for in-person care. Requirements necessary to comply with law, coding rules, or payor requirements, and requirements for credentialing, privileging, quality improvement, peer review, regulatory actions, CMS conditions, or the physician health program, are preserved. Violations involving telemedicine-exclusive practices are designated unfair or deceptive acts under the Consumer Protection Act, enforceable exclusively by the attorney general.

The bill makes violating the new medical-licensee restrictions unprofessional conduct and directs the secretary to investigate complaints involving the new prohibition on unlicensed practice, with existing cease-and-desist, civil-penalty, injunction, and criminal-enforcement authorities available. Applicants and renewal applicants for physician, osteopathic physician, advanced registered nurse practitioner, naturopath, and physician-assistant licenses must attest, in the form prescribed by the relevant board or commission, that they are aware of the new corporate-practice regulations. The franchise director may issue a stop order when a franchisor’s enterprise or business method includes activities illegal where performed, including violations of the new medical-practice ownership restrictions. The act takes effect January 1, 2028.

FULL SUMMARY

Beginning June 30, 2027, all noncompetition covenants are void and unenforceable regardless of when entered into. Employers may not enter into, enforce, attempt to enforce, threaten to enforce, or represent that an employee or worker is subject to such a covenant. By October 1, 2027, employers must notify current and former employees and independent contractors whose agreements contain or required them to sign a noncompetition covenant that it is void and unenforceable. Proceedings filed on or after the effective date apply the revised provisions regardless of when the cause of action arose; proceedings filed earlier remain governed by the prior law (pages 2–3).

The bill broadens the definition of a noncompetition covenant to cover restrictions on lawful work or performances, agreements directly or indirectly barring acceptance of or transactions with customers, and provisions requiring an individual to repay or forfeit compensation or benefits because of engaging in lawful work. Exclusions remain for nonsolicitation and confidentiality agreements, trade-secret or invention protections, qualifying ownership-sale covenants involving at least a one-percent interest, and qualifying franchise covenants. Nonsolicitation agreements are expressly limited to post-termination restrictions on soliciting the employer’s employees or current customers; restrictions on accepting or transacting business with a customer do not qualify (pages 1–2).

A violation permits the attorney general or an aggrieved person to seek all available relief. The violator must pay the greater of actual damages or a $5,000 statutory penalty, plus reasonable attorneys’ fees, expenses, and costs. The bill also directs liberal construction of worker-mobility protections and narrow construction of exceptions and nonsolicitation agreements, establishes that the chapter displaces conflicting state laws concerning employee or independent-contractor competition while preserving chapter 19.108 RCW, and repeals the provisions addressing independent-contractor noncompetition covenants, statutory dollar adjustments, and broadcasting-industry noncompetition agreements.

FULL SUMMARY

The bill establishes Labor Law § 191-d to prohibit employers and their agents from seeking, requiring, demanding, or accepting non-compete agreements from specified health-related professionals, including physicians, physician assistants, chiropractors, dentists, perfusionists, veterinarians, physical therapists, pharmacists, nurses, podiatrists, optometrists, psychologists, occupational therapists, speech pathologists, audiologists, and mental health practitioners. Covered non-compete agreements include provisions that bar practice with a new employer; impose penalties, repayment, or reimbursement obligations based solely or primarily on changing employers after work for a hospital, hospital parent, affiliated manager, or hospital system; require employer consent or submission to equitable relief; or indirectly limit or deter practice with a new employer. Nondisclosure agreements protecting confidential business information or trade secrets are excluded. Agreements entered into, required, or accepted after the effective date are null, void, and unenforceable.

A covered professional may sue within two years of the latest of the agreement’s signing, discovery, termination of the employment or contractual relationship, or an enforcement step. Courts may void the agreement, enjoin enforcement, and award liquidated damages of up to $10,000 per affected professional, along with lost compensation, compensatory damages, attorneys’ fees, and costs. The provision preserves agreements establishing fixed employment terms or exclusivity, protecting trade secrets or confidential and proprietary client information, and the operation of Labor Law § 202-k. Non-competes connected to the sale of business goodwill or a disposition of ownership interests remain permitted for sellers owning at least 15 percent, but must satisfy New York common-law enforceability requirements, may not exceed one year where reasonable in time, and must provide salary during enforcement. Choice-of-law and venue provisions cannot evade these requirements for professionals residing or employed in New York for at least the 30 days preceding cessation of employment, including certain remote workers reporting to New York.

The bill adds Labor Law § 45, requiring the Department of Labor to develop and provide employers with a notice describing these protections and rights and to post the notice on its website. Employers must post the notice conspicuously in accessible, well-lighted locations frequented by employees and applicants. The principal provisions take effect 30 days after enactment and apply prospectively to contracts entered into or modified on or after that date; the notice provision takes effect 180 days after enactment.

The bill adds a new provision to Tennessee’s Hospital Cooperation Act prohibiting hospitals from negotiating or entering into anti-competitive agreements or engaging in anti-competitive conduct with other hospitals in the state, notwithstanding other law. It also prohibits the use of state funds to facilitate or otherwise further the state’s active supervision of anti-competitive conduct in the health-care sector.

The provision applies to contracts and agreements executed, modified, or renewed on or after the act’s effective date. The act takes effect upon becoming law.

FULL SUMMARY

The bill adds Labor Law § 191-d to prohibit employers and their agents from seeking, requiring, demanding, or accepting non-compete agreements from covered individuals or health-related professionals. A covered individual is generally a worker economically dependent on and obligated to perform services for another person, excluding a highly compensated individual whose average annualized cash compensation is at least $500,000 based on specified W-2 and, where applicable, K-1 statements; that threshold is adjusted annually beginning in 2027 using the New York Consumer Price Index. Covered health-related professionals include specified licensed medical, dental, pharmaceutical, nursing, therapy, behavioral-health, veterinary, and related practitioners. Non-competes entered into after the effective date are void and unenforceable.

An affected individual may sue within two years of the latest of signing, learning of, termination of the relationship, or an employer’s enforcement step. Courts may void the agreement and award injunctive relief, lost compensation, compensatory damages, attorney’s fees and costs, plus mandatory liquidated damages of up to $10,000 per affected person. The provision preserves agreements concerning fixed service terms or exclusivity during employment, trade secrets, confidential or proprietary client information, and client non-solicitation, provided they do not otherwise restrict competition. It also preserves non-competes connected to a sale of business goodwill or a disposition of ownership by an owner holding at least 15 percent, subject to New York common-law enforceability requirements; permissible restrictions may not exceed one year and must provide salary during enforcement. Choice-of-law or venue clauses cannot evade these requirements for individuals who resided or worked in New York during the specified 30-day period before cessation of employment, including certain remote workers.

The bill adds Labor Law § 45, directing the Department of Labor to develop and publish a notice describing these protections and provide it to employers, which must post it conspicuously in locations frequented by employees and applicants. The act takes effect 30 days after becoming law and applies prospectively to contracts entered into or modified on or after that date; the notice provision takes effect 180 days after becoming law.

The document outlines a legislative proposal aimed at protecting medical practitioners, health care institutions, and health care payors in their exercise of conscience, whistleblower activities, and free speech. It grants these entities the right to refuse participation in health care services that conflict with their personal beliefs, ensuring they are shielded from discrimination for exercising this right.

Additionally, the proposal establishes whistleblower protections to prevent discrimination against individuals who report suspected violations of health care laws or ethical standards. It also safeguards the free speech rights of medical practitioners and institutions, protecting them from sanctions related to constitutionally protected speech unless it can be shown that such speech directly caused physical harm.

The bill allows entities that identify as religion-based to make employment and staffing decisions in accordance with their religious beliefs, while also removing civil, criminal, or administrative liability for exercising conscience. Furthermore, it mandates that health licensing boards address complaints within a specified timeframe.

Overall, the proposal emphasizes the potential implications for the health care industry, particularly concerning ethical practices, employment decisions, and the provision of health care services. It highlights the importance of protecting the rights of individuals and institutions in the context of their moral and ethical beliefs.

FULL SUMMARY

The bill prohibits employers—including private, public, nonprofit, and state employers—from seeking, requiring, accepting, enforcing, or representing that a worker is subject to a non-compete clause. The prohibition covers employees, independent contractors, interns, volunteers, apprentices, sole proprietors, and other paid or unpaid workers. For workers who are not senior executives, it applies to existing and future non-compete clauses; for senior executives, it bars new clauses and enforcement of clauses entered after the bill’s effective date. A senior executive is a policy-making worker whose prior-year or annualized compensation is at least $151,164. The bill also declares no-poach agreements void and contrary to public policy.

For non-senior workers, employers must provide clear notice within 30 business days after the effective date that existing non-compete clauses cannot and will not be enforced. Existing clauses for senior executives remain enforceable only if the employer provides a compliant written disclosure within that period and the clause satisfies detailed limits, including a maximum 12-month restriction, reasonable geographic and activity scope, protection of specified legitimate business interests, no waiver or penalty concerning worker rights, and continued pay and fringe-benefit contributions during the restricted period unless the worker was terminated for misconduct or breached the agreement. Exceptions cover clauses arising from a bona fide business sale and causes of action accruing before the effective date.

A worker may sue within two years of the latest of specified triggering events, and a court may void the agreement and award injunctive relief, lost compensation, damages, attorney’s fees, costs, and liquidated damages of up to $10,000. Employers must post the act or an approved summary; failure to post or provide required notices results in a written warning for a first violation, a fine of up to $250 for a second violation, and up to $1,000 for a third or subsequent violation. The act takes effect immediately.

FULL SUMMARY

The bill adds definitions to Massachusetts General Laws chapter 149 for “political matters,” covering elections, political parties, proposed legislative or regulatory changes, and decisions to join or support specified political, civic, community, fraternal, or labor organizations; and “religious matters,” covering religious affiliation and practice and decisions to join or support religious organizations or associations.

It adds section 20F, making an employer—including the Commonwealth and its political subdivisions—liable for disciplining or discharging, or threatening to do so, because an employee exercised First Amendment rights, unless the activity substantially or materially interfered with bona fide job performance or the employment relationship. Liability also applies when an employee refuses to attend an employer-sponsored meeting primarily intended to communicate the employer’s views on political or religious matters, or refuses to listen to or view communications, including electronic communications, primarily intended to convey those views. Available relief includes damages, punitive damages, lost wages or compensation, costs, and reasonable attorney’s fees.

The provision preserves employer communications required by law or necessary for employees to perform their duties; higher-education meetings and communications that are part of coursework, symposia, or academic programs; nonmandatory casual conversations; and requirements limited to managerial or supervisory employees. It excludes certain religious corporations, entities, associations, educational institutions, and societies exempt from specified federal or Massachusetts antidiscrimination requirements, but only regarding religious-matter speech directed at employees whose work is connected with those organizations’ activities.

The document outlines new regulations in California aimed at limiting the involvement of private equity groups and hedge funds in health care practices. A key provision prohibits these entities from interfering with the professional judgment of physicians and dentists regarding patient care, hiring practices, and billing procedures. This measure is designed to protect the autonomy of health care providers and ensure that clinical decisions remain solely in their hands.

Additionally, contracts that allow for interference with clinical decision-making or impose non-compete clauses on providers are rendered void and unenforceable. This further reinforces the independence of health care professionals in their practice.

The Attorney General is empowered to enforce these regulations, ensuring compliance and safeguarding the integrity of health care delivery in the state. The provisions are designed to remain effective even if any part is found invalid, maintaining the overall intent of the legislation.

Overall, the bill seeks to enhance the quality of health care in California by limiting the influence of non-licensed entities in clinical decision-making, thereby impacting the operations of health facilities, physician practices, and dental practices statewide.

The document outlines amendments to the Texas Business & Commerce Code that specifically address covenants not to compete for physicians and certain health care practitioners, including dentists and nurses. These changes aim to regulate the enforceability of non-compete agreements within the medical field.

One significant amendment is the limitation on the buyout amount for non-compete covenants. For physicians, this amount cannot exceed their total annual salary and wages at the time of termination, and similar provisions apply to other health care practitioners, ensuring equitable treatment across the professions.

Additionally, the amendments impose geographical and temporal restrictions on non-compete agreements. Such agreements must limit the geographical area to a maximum of a five-mile radius from the practitioner's primary practice location and must expire no later than one year after the termination of employment.

These changes are designed to provide clearer guidelines and protections for health care practitioners in Texas, particularly regarding their ability to continue practicing and accessing patient information after leaving a position. The new regulations will take effect for agreements entered into or renewed on or after September 1, 2025, while prior agreements will remain governed by existing laws.

FULL SUMMARY

The bill adds Labor Law § 191-d to prohibit employers and their agents from seeking, requiring, demanding, or accepting non-compete agreements from covered individuals and specified health-related professionals. “Covered individual” excludes a highly compensated individual, defined as someone with average annualized cash compensation of at least $500,000 based on recent W-2 and applicable K-1 statements; the threshold is adjusted annually beginning in 2027 based on the New York Consumer Price Index. Non-compete agreements entered into after the section’s effective date would be void and unenforceable. Covered individuals may sue within two years of the latest of signing, learning of the agreement, termination of the relationship, or an enforcement step, with available relief including injunctions, lost compensation, compensatory damages, attorney’s fees and costs, and mandatory liquidated damages of up to $10,000 per affected individual.

The bill preserves agreements establishing a fixed employment term or exclusivity during employment, protecting trade secrets or confidential and proprietary client information, or restricting client solicitation, provided they do not otherwise unlawfully restrain competition. It also permits non-compete agreements connected to the sale of business goodwill or a majority ownership interest when the seller owns at least 15 percent of the business, subject to New York common-law enforceability requirements, a maximum one-year restriction, and salary payment during enforcement. New York choice-of-law or venue provisions cannot evade these requirements for individuals who resided or worked in New York for at least the 30 days before employment ended, including certain remote workers. Employers must post notice of these rights; the Department of Labor must develop and publish the notice. The provisions take effect 30 days after enactment and apply prospectively to contracts entered into or modified thereafter, while the notice provision takes effect 180 days after enactment.

The bill deletes Tennessee Code Annotated § 63-1-160(g). It takes effect upon becoming law, with the public welfare requiring it.

FULL SUMMARY

The bill changes Tennessee physician-employment statutes by removing multiple provisions that exclude radiologists, anesthesiologists, pathologists, and emergency physicians from existing employment-related rules. In Tennessee Code Annotated § 63-6-204, it deletes specified subdivisions and subsection provisions, removes specialty exclusions from subsections (d), (f)(1), and (g)(1), and eliminates a restriction limiting certain faculty-practice-plan physicians in those specialties to institutions where they practiced as of May 30, 1997. It also narrows a specialty reference in subsection (h)(5)(A) from ophthalmology, pathology, anesthesiology, and emergency medicine to ophthalmology alone, and deletes § 63-9-104(f)(3).

For hospitals and hospital affiliates under § 68-11-205, the bill deletes specified subdivisions and subsection (g), and removes exclusions for radiologists, anesthesiologists, pathologists, and emergency physicians from subsections (b)(1) and (c)(1). It adds provisions to both §§ 63-6-204 and 68-11-205 stating that the statutes do not require a particular employment relationship for these four specialties, provided the employment otherwise complies with the applicable chapter or part. “Employment relationship” expressly includes both direct employment and employment through a third-party agreement.

The act takes effect July 1, 2025.

Section 63-6-204(f)(2)(A)(iv) of the Tennessee Code is changed to extend the applicable deadline from 10 business days to 30 business days. The change takes effect upon becoming law.

The bill changes the deadline in Tennessee Code Annotated § 63-6-204(f)(2)(A)(iv) from 10 business days to 30 business days. The act takes effect upon becoming law.

The proposed legislation in North Carolina aims to enhance job mobility and empower workers by prohibiting non-compete agreements and repealing restrictions on labor organizing and collective bargaining. The prohibition on non-compete agreements will take effect on July 1, 2025, and will apply to all agreements entered into after that date. This change is expected to benefit various sectors, particularly those with significant labor mobility concerns, such as construction trades, cosmetology, health-related professions, and personal care services.

Additionally, a study will evaluate the impact of occupational licensing on individuals, especially those with moderate or low incomes, and the overall market. The study will involve various licensed professions and consider the effects of licensing regulations on small business owners and entrepreneurs. It will identify licensing rules that lead to significant increases in consumer prices or reductions in market competition for potential modification or repeal.

Stakeholder engagement is a key component of the study, with public hearings planned across different regions of North Carolina to gather input from individuals, businesses, and organizations. An interim report on the study's findings and recommended legislation will be submitted to the General Assembly in 2025, followed by a final report in 2027 that will include specific recommendations for unnecessary or overly restrictive licenses.

Overall, the legislation seeks to create a fairer labor market by removing exploitative employment practices and ensuring that occupational licensing requirements do not hinder lawful work and economic participation, particularly for low-income individuals.

FULL SUMMARY

The bill establishes Revised Code Chapter 4119 and defines “worker” broadly to include employees, independent contractors, externs, interns, volunteers, apprentices, sole proprietors, and individuals providing services through a business or nonprofit entity. Employers would be prohibited from entering into, attempting to enter into, presenting as a hiring term, or enforcing agreements that restrict a worker from seeking or accepting work or operating a business after the work relationship ends. Prohibited provisions include noncompetition restrictions, lost-profit or liquidated-damages requirements, termination fees such as replacement-hire or retraining fees, immigration or visa-cost reimbursement, bondage fees, and repayment of employer expenses for training, orientation, evaluation, or similar services. Agreements entered into, modified, or extended after the provision takes effect would be void.

For workers who primarily reside and do business in Ohio, employers generally could not condition employment on agreeing to litigate Ohio-related claims outside Ohio or on waiving substantive legal protections provided by Ohio law. Violating provisions would be void, with Ohio venue and law governing the dispute. This restriction would not apply when the worker is individually represented by legal counsel in negotiating the agreement and, at the worker’s option, selects the venue, forum, or governing law; counsel paid for or selected at the employer’s suggestion would not qualify. The bill preserves government debt forgiveness, post-employment benefits, and federal, state, or local loan-repayment assistance or loan-forgiveness programs.

Workers and prospective workers could sue for violations and, if successful, would receive costs and reasonable attorney’s fees, with courts authorized to award actual damages, punitive damages capped at $5,000, and injunctive relief. They could also file complaints with the Attorney General or the Director of Commerce. Each office would investigate complaints; the Attorney General could bring an action where a violation likely occurred, while the Director would refer substantiated complaints and investigation results to the Attorney General. The two officials would be required to coordinate through a written agreement, and the chapter would preserve rights and obligations under state or federal laws specifically regulating consumer financial transactions and related products or services.

The document outlines amendments to the South Carolina Code of Laws that focus on healthcare contracts, particularly concerning the physician-patient relationship and the corporate practice of medicine. These changes are expected to have a significant impact on the healthcare industry, especially for physicians and healthcare entities such as hospitals and health systems.

One key provision requires physicians who have been employed for less than three years to repay relocation expenses, signing bonuses, or other inducements if stipulated in their contracts. However, the amendments do not restrict the buying and selling of independent physician practices, allowing noncompete agreements to last for a maximum of five years.

The amendments aim to enhance the protection of the physician-patient relationship while reducing corporate influence over medical practices. Additionally, they establish remedies for any violations of these provisions. Overall, the changes are designed to promote a more ethical and patient-centered healthcare environment.

The proposed legislation amends Title 18 of the Pennsylvania Consolidated Statutes to address the offense of terroristic threats. A significant change is the requirement for individuals convicted of such offenses to pay restitution for costs associated with evacuations, which may include expenses related to fire and police responses, emergency medical services, and transportation of individuals from affected areas.

Additionally, the bill introduces a sentencing enhancement for cases involving terroristic threats directed at educational institutions, encompassing public schools, charter schools, private schools, and institutions of higher education.

The legislation is expected to impact various business sectors, including emergency services, law enforcement, and educational institutions, due to the financial implications of the restitution requirements and the enhanced sentencing provisions.

The bill requires Aging and Disability Resource Connection (ADRC) programs to provide community education on disaster and emergency preparedness specifically for older adults and people with disabilities. The education must inform them about preparedness and promote safety before, during, and after natural disasters and other emergency events.

The education may use existing tools developed by the California Office of Emergency Services, the California Department of Aging, the Department of Rehabilitation, the State Department of Developmental Services, and other relevant community partners. It must raise awareness of available resources and guidance, including local alert systems and emergency plans, fire department information, emergency transportation and evacuation resources, and utility-service information during emergencies and disasters.

The legislative findings identify heightened risks faced during disasters by people with access and functional needs, including older adults and people with disabilities, and cite barriers involving alerts and warnings, evacuation, and sheltering.

FULL SUMMARY

The Hospital Licensing Act is revised to define “pathogens of epidemiological concern” as infectious agents presenting specified risks, including transmission within health care facilities, clusters affecting two or more patients, antimicrobial resistance, serious disease or increased morbidity or mortality, newly discovered or reemerging pathogens, or other characteristics identified by a state or local health department.

Hospital infection-control obligations are expanded from multidrug-resistant organisms to pathogens of epidemiological concern generally. The Department of Public Health must adopt rules requiring hospitals to conduct annual facility-wide infection-control risk assessments and enforce hand-hygiene and contact-precaution requirements. Hospitals must also maintain comprehensive prevention and control interventions informed by applicable federal guidance and specified infectious-disease and infection-control organizations.

Within 12 months after the Act’s effective date, each hospital must adopt a transmission-prevention policy that includes a facility risk assessment addressing pathogen occurrence, potential impact, and mitigation measures for patients, health care workers, and visitors, as well as evidence-based procedures to identify carriers and prevent transmission. Hospitals that identify a patient carrying a pathogen of epidemiological concern through appropriate testing must report the patient to the U.S. Department of Health and Human Services or the CDC’s National Healthcare Safety Network as required by the Illinois Department of Public Health or the federal Centers for Medicare and Medicaid Services. The MRSA Screening and Reporting Act is repealed, effective January 1, 2027.

FULL SUMMARY

The bill changes Executive Law § 29-b to authorize the governor to deploy non-state resource providers to another compact-member jurisdiction. When authorized and deployed by the legally designated state official or officials, those providers are treated as state agents for the deployment and receive the rights and benefits available to state resource providers under the compact, subject to the requesting state’s terms and conditions. Non-state providers may not independently offer assistance to, or request assistance from, another compact-member jurisdiction.

The Division of Homeland Security and Emergency Services is designated as the coordinator for assistance offers and requests and as the facilitator of reimbursement by the requesting state. The division is not responsible for reimbursement until it receives payment from the requesting compact-member jurisdiction. The bill also changes the governor’s referenced pronoun in the existing provision from “his or her” to “their.”

New Executive Law § 29-k authorizes New York, through the governor, to enter the Northern Emergency Management Assistance Compact (P.L. 112-282), with legislative ratification deemed to occur when the governor certifies New York’s entry to the temporary Senate president, Assembly speaker, and secretary of state. New § 29-l similarly authorizes entry into the international emergency management assistance compact established under the July 18, 2000, emergency management memorandum of understanding among specified New England states and Canadian provinces, subject to the same certification-based ratification process. The act takes effect immediately.

FULL SUMMARY

The Act establishes a statewide air medical services program within the Department of Health’s emergency medical services and injury prevention systems branch. The program is responsible for governance, coordination, oversight, quality improvement, data management, and disaster readiness for emergency aeromedical and interfacility air medical transport. The department must create three permanent, recurring positions exempt from chapter 76: a state air medical director, a state air medical program manager, and an air medical coordinator, with responsibilities covering clinical oversight, administration and policy development, system planning, operational coordination, compliance monitoring, data oversight, and performance improvement.

Under the direction of the director of health, the program may establish statewide policies, procedures, and clinical protocols consistent with nationally recognized standards; coordinate air medical transport across counties; oversee provider participation in data-based quality improvement; support disaster preparedness, response, and recovery, including multi-island and mass-casualty incidents; and coordinate with emergency medical services agencies, hospitals, trauma and stroke centers, acute-care facilities, emergency management agencies, and other partners. As a condition of licensure, all air medical providers operating in Hawaii must participate in department-required statewide coordination, data-reporting, and quality-improvement activities. The program must coordinate with the state emergency medical services advisory committee and may establish advisory or quality-improvement committees.

The department must establish annual, reasonable, nonrefundable air medical ambulance licensure and accreditation fees sufficient to cover program administration, licensure and accreditation verification, compliance and enforcement, coordination and quality-improvement initiatives, data requirements, and emergency-management coordination. Fees must be deposited in the emergency medical services special fund and used solely for the statewide program, its staff, and related emergency-management coordination. The fund’s distribution provisions are revised to create this dedicated fee-funded allocation while retaining the existing $3.5 million annual county distribution and directing the remaining balance to department system operations. The Act takes effect upon approval.

FULL SUMMARY

Effective October 1, 2026, municipal fire departments must notify the Department of Emergency Services and Public Protection within 10 business days after appointing a new or interim fire chief, using a commissioner-prescribed form. The act changes evidentiary language for breath-test results in motor-vehicle and boating-related prosecutions, including revised requirements concerning delivery of test-result reports and additional chemical tests. DNA collection deadlines are moved from release or discharge to no later than six months after sentencing or entry into custody, supervision, or jurisdiction for specified offenders, and the act requires a statewide study of lawfully owed but uncollected DNA, with a report due July 1, 2027. It also revises the membership of the Police Officer Standards and Training Council, removes an obsolete State Police staffing-standards study requirement, and requires biennial State Police staffing reports to assess public-safety impacts when recommended staffing falls below 1,248 sworn personnel.

The act changes fireworks and special-effects certification requirements. Applicants must provide evidence of good moral character and competence, undergo state and national criminal-history checks, and pay specified fees; certificates renew every three years, are nontransferable, and may be suspended or revoked by the commissioner for cause. It authorizes special permits for professional bondsmen, surety bail bond agents, and bail enforcement agents to carry electronic defense weapons, in addition to firearms, subject to approved training; permits carry a $62 application or renewal fee, require annual safety refresher training as a renewal condition, and are coordinated with the state pistol permit. Security-officer licensing provisions are revised to recognize specified equivalent training for correctional, parole, judicial-marshal, police, military, and National Guard personnel; bar licensure for decertified police officers; allow qualified applicants to work while applications are pending based on specified background-check and training conditions; and require prompt completion of incomplete applications. The act also establishes a $75-per-offense penalty for violations of specified security-officer requirements.

Risk-protection-order procedures are revised to require a court hearing within 14 days, retain the clear-and-convincing-evidence standard, establish a petition process beginning 180 days after the initial hearing, require local police probable-cause review of termination petitions, and require immediate removal of terminated orders from the National Instant Criminal Background Check System. Persons whose firearms or ammunition are seized may transfer them to a federally licensed dealer, which the holding agency must deliver within 10 days after written notice; destruction is delayed until at least two years after the initial hearing, with at least 90 days’ written notice. Youth-camp law is changed to exempt Connecticut Wing Civil Air Patrol camps meeting specified state-property, facility, and medication-management conditions from licensing. The definition of “police patrol vehicle” is narrowed to exclude administrative vehicles with body-worn-camera users, bicycles, motor scooters, all-terrain vehicles, specified mobility devices, and animal-control vehicles.

Effective July 1, 2026, “targeted violence” is defined as a premeditated act directed at an individual, group, event, or location, irrespective of motive, and typically not connected with other criminal activity. State civil-preparedness plans prepared on or after July 1, 2027, must address targeted violence and terrorism prevention. Municipalities must submit emergency plans biennially to the commissioner for approval after local approval; shoreline municipalities must submit plans for legislative committee review and a public hearing, and the commissioner may approve such plans only if they address all civil-preparedness activities and measures. Municipal plans may include animal evacuation and sheltering provisions and targeted-violence and terrorism-prevention provisions. Finally, the police training center for crime-scene processing, forensic evidence, and criminal investigations may be located at any institution of higher education within the Connecticut State Colleges and Universities, and the required memorandum of understanding is due by January 1, 2027.

FULL SUMMARY

The Department of Emergency Management must assess the feasibility and impact of creating a program to prioritize prevention and mitigation for anticipated impacts of an imminent emergency requiring a gubernatorial declaration of a state of preparedness, or for an emergency that does not warrant a gubernatorial declaration of a state of emergency. The act defines “state of preparedness” as a condition declared by the Governor when a credible emergency or disaster is sufficiently severe to warrant state preparedness assistance and pre-positioning of resources.

The assessment must develop recommendations on criteria for Department response to emergencies below the state-of-emergency threshold; procurement, maintenance, replenishment, quantities, and locations of supplies and equipment needed for readiness; the feasibility of seeking reimbursement from persons causing or contributing to an emergency or disaster; and cost estimates for personnel, administrative, and equipment expenses incurred by the Department, other state agencies, political subdivisions, or other entities in responding to qualifying emergencies.

The Department must report its findings and recommendations to the Governor and specified legislative committee chairs by November 1, 2026.

FULL SUMMARY

The bill directs the Department of Emergency Management to assess the feasibility and impact of creating a program focused on preventing and mitigating damage, loss, hardship, or suffering from imminent emergencies that could prompt a gubernatorial declaration of a state of preparedness, as well as emergencies that do not warrant a gubernatorial state-of-emergency declaration. It defines “state of preparedness” as a condition declared by the Governor when a credible emergency or disaster is sufficiently severe to warrant state disaster-preparedness assistance that supplements local preparedness and pre-positions resources.

The assessment must develop recommendations on criteria for Department responses to emergencies below the state-of-emergency threshold; procedures for procuring, maintaining, and replenishing materials, equipment, and supplies in quantities and locations needed for readiness and protection of lives, property, and economic well-being; the feasibility of seeking reimbursement from persons who cause or contribute to an emergency or disaster; and projected personnel, administrative, equipment, and other costs for responding to qualifying emergencies.

The Department must report its findings and recommendations to the Governor and specified legislative committee chairs by November 1, 2026.

FULL SUMMARY

The bill establishes the “Tom’s Friends with ALS Bill of Rights” for people with amyotrophic lateral sclerosis (ALS) and specified motor neuron diseases, including progressive bulbar palsy, primary lateral sclerosis, progressive muscular atrophy, spinal muscular atrophy, Kennedy’s disease, and post-polio syndrome. It creates rights to equitable in-home hygiene and health care services, including nail care, hair care, and therapy, and provides that therapists delivering services they otherwise provide outside the home need not obtain additional licensure. Public and private insurers may not require prior authorization for covered durable medical equipment—such as non-invasive ventilators, cough-assist machines, and suction machines—or liquid medications for these patients.

Patients receiving palliative, comfort, or hospice care must retain access to durable medical equipment and speech therapy previously provided, may not be denied a request for an inpatient bed, and must receive a bed as soon as practicable or be transferred to a facility with an available bed. The Department of Health must create, within 120 days after the act’s effective date, free annual continuing-medical-education-compliant training on changing patient needs for nurses, physical therapists, physicians, occupational therapists, and respiratory therapists who work with covered patients; emergency-room physicians must complete the training annually and know applicable American Academy of Neurology best practices. The Commissioner of Human Services must seek Medicaid state-plan amendments or waivers and federal financial participation, but the State need not implement the section 3 provisions in Medicaid if federal waivers are not obtained. The act takes effect immediately.

The bill requires each county behavioral health director to establish and implement procedures governing the designation and training of professionals authorized to perform functions under Welfare and Institutions Code Section 5150, replacing the prior authorization to develop such procedures. The change creates additional duties for county behavioral health directors and therefore may constitute a state-mandated local program.

If the Commission on State Mandates determines that the bill imposes state-mandated costs, reimbursement to affected local agencies and school districts must be provided under the applicable statutory reimbursement procedures.

FULL SUMMARY

The bill inserts a new subdivision into RSA 151 governing patient choice and transfer practices at freestanding hospital emergency facilities (FHEFs). A licensed FHEF must give a patient or, when applicable, the patient’s legal representative the opportunity to choose the receiving hospital when transfer is medically necessary and the hospital can meet the patient’s needs. It may not restrict or direct transfers exclusively to its affiliated parent hospital unless federal law requires that result, and it must record the patient’s transfer choice in the medical record. If the patient cannot choose, the FHEF must arrange transfer to the closest appropriate hospital capable of addressing the patient’s needs.

The bill prohibits an FHEF or its owner or operator from conditioning treatment or discharge on transfer to an affiliated or parent hospital based on whether the patient has insurance, steering or coercing patients or using misleading communications to limit transfer choice, or entering into EMS policies or contracts that require or encourage exclusive transfer to an affiliated or parent hospital.

The Department of Health and Human Services commissioner must issue interim rules under RSA 541-A:19 and adopt final rules by June 30, 2027. Patterns of violations must be referred to the Department of Justice and are designated unfair or deceptive acts or practices under RSA 358-A:2, with the enforcement rights and remedies available under RSA 358-A. The act takes effect upon passage.

FULL SUMMARY

The bill makes broad changes to Medi-Cal eligibility and administration to conform to federal H.R. 1. Beginning no sooner than January 1, 2027, after required systems programming and federal approvals, specified adults ages 19 through 64 must demonstrate work or community engagement for at least 80 hours per month, half-time education, qualifying income, or a combination of activities; numerous exemptions and short-term hardship protections apply. Counties must provide notice and a 30-day opportunity to establish compliance before denial or disenrollment, determine other bases of eligibility, and provide fair-hearing rights. Certain Medicaid-expansion adults become subject to six-month redeterminations no sooner than March 1, 2027, while retroactive coverage is reduced to one month for that group and two months for other applicants. The department must establish address-verification and multistate-enrollment controls, coordinate outreach, accept specified electronic and telephonic signatures, and operate a publicly downloadable quarterly dashboard by January 1, 2028. Beginning July 1, 2027, subject to federal approval and system readiness, non-MAGI Medi-Cal eligibility uses resource limits of $21,000 for a one-person household, $31,000 for two people, and $1,550 for each additional member, up to 10 members. The bill also changes eligibility and service limits for specified immigrants, including restricted-scope coverage and monthly premiums of between $30 and $50 for certain adults, delays the related dental-service limitation to July 1, 2027, and reduces the Medi-Cal retroactive eligibility period. It extends CalAIM through December 31, 2031, authorizes Employment Supports and BridgeCare, requires participating Drug Medi-Cal counties to use a single prepaid inpatient health plan, and redirects managed-care medical-loss-ratio remittances to the General Fund.

The bill establishes or changes health-facility and provider regulation. It authorizes general acute care hospitals to license one skilled-nursing distinct part, including a composite distinct part composed of noncontiguous components, subject to hospital ownership, governance, integration, licensing, staffing, access, and resident-segregation restrictions. It expands a 10-year standby perinatal-services pilot to up to five critical access hospitals and adds a qualifying nonprofit hospital in Lake County among the first three selected, while revising operational, staffing, training, equipment, reporting, and flexibility requirements. Home health agencies must identify specified management personnel, submit résumés and facility affiliations, demonstrate geographic unmet need, undergo expanded verification and enforcement, and generally may not transfer a license or change ownership during the first five years; a moratorium on new licenses and branch offices applies subject to unmet-need exceptions. Substance-use-disorder provisions replace “detoxification” terminology with “withdrawal management,” phase out detoxification-only licenses on July 1, 2027, require updated ASAM-based rules by January 1, 2030, and expand related licensing and oversight provisions. The bill also creates a Hospital Fair Pricing Penalties Fund, expands allowable uses of the AIDS Drug Assistance Program Rebate Fund, establishes a permanent independent placement panel for forensic conditional release, and modifies outpatient-placement review procedures.

The bill requires health plans and insurers, beginning with policies and contracts issued, amended, or renewed on applicable operative dates, to cover medically necessary FDA-approved menopause treatments—including hormone therapies, low-dose antidepressants, anticonvulsants, osteoporosis medications, and nonhormonal vasomotor treatments—and to provide menopause information, assessments for individuals age 40 and older, provider reimbursement policies, and incentives for menopause-qualified providers. Beginning January 1, 2027, utilization review for menopause care must follow nationally recognized menopause-care criteria without conflicting or more restrictive standards, subject to defined exceptions. Medi-Cal receives corresponding coverage and reimbursement requirements, and qualifying physicians, osteopathic physicians, nurse practitioners, and physician assistants receive enhanced continuing-education credit for menopause-care coursework. The bill transfers quality-of-care and consumer-assistance reporting functions to the Department of Health Care Access and Information, requires annual, biennial, and alternating-year public reports using deidentified or aggregated data, and establishes privacy safeguards. It also requires that specified health entities execute and use the California Health and Human Services Data Exchange Framework, gives the department oversight and public-compliance-reporting authority, delays compliance for specified clinics and rural health clinics to July 1, 2027, and excludes specified sensitive information from mandatory exchange. Behavioral Health Services Act counties receive new minimum-expenditure, reserve, planning, reporting, and sanction requirements, including department authority to impose corrective plans, monetary sanctions, or payment withholding. The act takes effect immediately.

FULL SUMMARY

The act appropriates $34.374 billion in net General Fund spending for fiscal year 2026-2027, $3.382 billion from the Highway Fund, and $2.568 billion from the Highway Trust Fund, while reserving $450 million for the Savings Reserve and establishing or funding multiple technology, stabilization, Medicaid, housing, economic-development, emergency-response, and disaster-relief reserves. It appropriates and reallocates $706.1 million for Hurricane Helene recovery, including federal cost shares, housing repair, private-road and bridge reconstruction, local-government and volunteer-fire-department grants, temporary relocation assistance, dam safety, wildfire mitigation, cash-flow loans, landslide mapping, and flood gauges. It also creates a $10.7 million Tropical Storm Chantal water-infrastructure fund, modifies disaster-program eligibility, procurement, reporting, repayment, reversion, and alternative-funding requirements, and extends or changes deadlines for specified recovery projects.

In education, the act establishes or expands programs for competency-based learning, digital credentials, workforce diplomas, high-cost community-college programs, intellectual and developmental disability workforce training, literacy and mathematics intervention, AI literacy and AI-use policies, school safety, attendance intervention, career and technical education, robotics, college-access advising, teacher apprenticeships, principal internships, and nursing education. It replaces the State Textbook Fund with an Instructional Materials allotment, expands reading assessments and individual reading plans through fifth grade, requires mathematics screening and success plans in low-performing schools, prohibits alternate school meals based on payment status, requires schools to provide crisis-lifeline information, mandates cardiac emergency response plans and at least one AED per public school, and establishes the Northeast Regional School of Biotechnology and Agriscience. It provides specified salary schedules, a 3% increase for many State, UNC, and community-college employees, bonuses for qualifying educators and school-support personnel, supplemental compensation programs, and revised retirement and benefit provisions.

The act makes extensive structural and regulatory changes across State government. It establishes or reorganizes boards, commissions, offices, funds, and programs, including the Office of Learning Research, the Building Codes and Interpretations Bureau within the Department of Labor, the Council of District Attorneys, the Rural Residency Medical Education and Training Fund, emerging-contaminant mitigation grants, and new trade commissions. It changes Medicaid financing, eligibility monitoring, provider networks, reimbursement rates, cost-containment pilots, direct-care-worker rates, and hospital assessments; creates PFAS sampling and mitigation requirements; imposes surgical-smoke evacuation policies; expands certain child-care, public-health, and social-service programs; and modifies public-records, procurement, licensing, and inspection rules. It also changes criminal penalties and investigative authorities, transportation and ferry tolling and registration systems, land-development litigation and permit-choice rules, building-code administration, environmental permitting and interbasin-transfer restrictions, insurance and professional licensing fees, sports-wagering and prediction-market taxes, personal-income-tax rates, and local education sales-tax authority. Unless a provision specifies otherwise, the act is effective July 1, 2026.

FULL SUMMARY

The bill requires each hospital with an emergency department to establish evidence-based pediatric-care policies covering triage, vital signs, weight measurement and recording in kilograms, medication-dose calculations, and pediatric instruments. Hospitals must provide annual training on those policies, including licensure-appropriate pediatric-instrument simulation, and conduct annual emergency drills. Each emergency department must designate a qualified pediatric emergency care coordinator responsible for implementing and maintaining fidelity to the policies, and must conduct the National Pediatric Readiness Assessment according to the National Pediatric Readiness Project’s schedule. In years without that assessment, hospitals may conduct the Project’s Open Assessment.

The Agency for Health Care Administration must adopt, in consultation with the Florida Emergency Medical Services for Children State Partnership Program, rules establishing minimum standards for pediatric care in hospital emergency departments, including the availability and immediate access to pediatric-specific equipment and supplies. Comprehensive emergency management-plan standards must also address the needs of pediatric and neonatal patients. The agency must collect each hospital emergency department’s overall National Pediatric Readiness Assessment score by December 31, 2026, and annually thereafter when the assessment is conducted; beginning April 1, 2027, it must publish each department’s score and compare it with the national average when available. For Open Assessments, the agency may collect and publish no more than one overall score per hospital per year and must compare it with the department’s most recently published score. The act takes effect July 1, 2026.

FULL SUMMARY

The act appropriates funding for Massachusetts fiscal year 2027, ending June 30, 2027, including approximately $62.5 billion in projected total revenues and appropriations across state agencies, federal grants, trust-fund transfers, debt service, and capital and operating programs. It provides $7.658 billion in Chapter 70 school aid and $1.376 billion in unrestricted general government aid to municipalities, establishes detailed agency spending conditions and reporting requirements, and directs funding for health and human services, early education, housing and homelessness assistance, public safety, behavioral health, transportation, higher education, environmental programs, veterans’ services, and workforce development. Major program conditions include expanded or protected MassHealth, child care, emergency shelter, rental assistance, school meals, free community college, regional transit, substance-use treatment, and reentry services.

The act amends state law to create or modify several funds and oversight structures. It establishes the Thomas P. Kennedy Spinal Cord Injury Trust Fund, the Massachusetts National Guard Museum, the Retired Police Dog Care Fund, a standing stabilization fund and long-term liability financing task force, and a Workforce Productivity Subfund with grants for employers with no more than 50 employees. It changes sports-wagering revenue distributions, gaming revenue allocations, pension-liability funding schedules, and excess-capital-gains transfers; authorizes specified transfers to the Health Safety Net, Medicare Savings Programs, climate technology, and other trust funds; permits MassHealth to negotiate certain supplemental rebates and limits or modifies adult dental coverage; and imposes fiscal controls, potential receivership, and monthly reporting requirements on sheriff’s offices that exceed appropriations or fail financial-management standards.

The act makes substantive changes to zoning, elections, consumer protection, labor, insurance, criminal law, and public safety. Zoning notices may be delivered electronically; certain nonconforming structures may be expanded as of right; permit protections and variance standards are revised; and municipalities may regulate abandoned nonconforming uses after four years. Candidate filings and ballots generally replace residential street addresses with municipalities, wards, or precincts, while residential addresses are protected from public disclosure except for qualification challenges. New negative-option consumer rules require simple cancellation methods and advance written disclosures, with violations treated as unfair or deceptive practices. Youth employment-permit procedures may be electronic, and client employers and contract workers are added to certain workplace-protection provisions. The act establishes a minimum auto-body labor reimbursement rate, creates offenses for specified sexual conduct by mandated reporters involving minors, extends DNA-based charging beyond ordinary limitation periods in specified sexual-assault cases, and requires sexual-assault evidence kits to be tracked, collected within three business days, submitted for testing within seven business days when applicable, tested within 30 days, retained for at least 15 years, and entered into CODIS when a DNA profile results.

The act also requires studies, task forces, and implementation plans on eviction-record sealing, endometriosis, wrong-way driving, older-driver roadway safety, municipal aid distribution, transition services for young people with disabilities, school-building funding, foundation-budget review, emergency medical services, and a potential transfer of Bridgewater State Hospital oversight to the Department of Mental Health. It requires a statewide wrong-way-driving prevention protocol, related peace-officer training beginning January 1, 2027, and annual public-service announcements. Except where otherwise specified, the act takes effect July 1, 2026; the youth-employment provisions in section 58 take effect three months later, and the election-related provisions in sections 37 through 48 take effect January 1, 2027.

The bill adds an exception to Minnesota’s hospital construction moratorium for a project to add 85 licensed beds at an existing safety-net, level I trauma center hospital in Ramsey County designated under Minnesota Statutes, section 383A.91, subdivision 5. The new exception is added as clause (35) to section 144.551, subdivision 1, paragraph (b).

FULL SUMMARY

The bill establishes a statewide system to study the delivery of emergency medical care to people in custody, including individuals under arrest, being transported for incarceration, or held in jails, prisons, and juvenile facilities. Within 365 days after enactment, the state administering agency for the federal Death in Custody Reporting Act, in consultation with municipal and college law-enforcement agencies, county houses of correction and jails, state prisons, other state agencies with arrest or lock-up authority, and emergency medical services, must submit information on that care to the Massachusetts Attorney General.

The Attorney General, in conjunction with the state administering agency, must annually acquire, collect, classify, and study the data and report uniformly when and how emergency care was summoned and provided. The annual report must address the frequency, nature, and timing of care; emergency-department admissions and hospitalizations and limited causes; EMS activations and primary impressions; and clinical information about care provided before a custodial death. It must also cover psychiatric crises during arrest, including prior three-digit crisis reports, EMS or hospital care, and uniform summaries of critical-incident responses where co-response medical data is not integrated into an electronic medical record. The resulting yearly report must summarize the nature or primary impression of medical needs, the prevalence of emergencies, and whether care was provided timely.

The document outlines amendments to regulations concerning the use of health care kiosks in emergency departments of hospitals. These changes primarily impact hospitals, particularly those with emergency services, as they will need to modify their kiosk operations.

Under the new regulations, hospitals are prohibited from using health care kiosks to assess a patient's medical condition, prioritize injuries or illnesses, or triage patients. However, kiosks can still be utilized for the entry of personal identifying and billing information, replacing traditional paper forms.

The amendments are set to take effect on January 1, 2027. The intent of these regulations is to ensure that patient assessment and triage are conducted under the direct supervision of medical professionals, while still allowing for some administrative efficiencies through the use of kiosks.

FULL SUMMARY

The bill establishes the “Medical Civil Rights Act” and takes effect immediately. It revises Civil Rights Law § 28 to cover individuals who are in direct audio or visual contact with, or under the custody or control of, a law enforcement officer, peace officer, police officer, correctional officer, or other law-enforcement representative or entity—not only individuals under arrest or custody.

Covered individuals experiencing an emergency medical condition or who are medically unstable receive a right to emergency medical services. Covered personnel and entities must provide attention to emergency medical needs and immediately request emergency medical services when the condition is communicated to them or reasonably observed. They are excused from requesting services only when they reasonably determine that no emergency condition or medical instability exists and know the person was examined and released by a medical professional within the preceding 24 hours after that determination. When medical personnel are simultaneously involved, law-enforcement personnel must immediately allow them to begin treatment when the condition is reported or reasonably apparent.

A person who does not receive emergency medical treatment and consequently suffers serious physical injury or significant exacerbation of an injury or condition may sue the responsible officer, representative, or entity. Courts must award reasonable attorneys’ fees to a successful plaintiff, in addition to actual damages and costs. The bill defines “emergency medical condition,” “medically unstable,” “correctional officer,” “law enforcement representative,” and “medical personnel,” while incorporating existing Criminal Procedure Law definitions for “police officer” and “peace officer.”

The bill creates the Compassionate Assistance for Rape Emergencies (CARE) Act. Hospitals and affiliated urgent-care facilities providing emergency care to sexual-assault victims must orally inform each patient of the option to receive emergency contraception, immediately provide the complete emergency-contraception regimen upon request, and provide sexually transmitted infection screening and treatment. The Department of Health and Senior Services must promulgate implementing rules, subject to Missouri’s administrative-rule procedures and the bill’s nonseverability provisions.

The bill removes the requirement that the Department of Public Safety, when reviewing a forensic-examination reimbursement claim submitted within 90 days, apply specified minimum criteria requiring itemized examination charges to fall within the statutory definition of a forensic examination. Other reproduced provisions governing forensic examinations, reimbursement, evidentiary kits, evidence handling, tracking, and retention are not changed by the marked text.

FULL SUMMARY

Virginia’s hospital regulations must continue to require at least one licensed physician primarily responsible for the emergency department to be on duty and physically present at all times, but the requirement is made inapplicable to certain psychiatric emergency departments. An exception applies to a psychiatric emergency department immediately adjacent to an emergency department providing emergency medical treatment if protocols require an immediate physician response to all medical emergencies.

A separate exception applies to a psychiatric emergency department in the City of Hampton that presents itself as providing only psychiatric services and not emergency medical treatment, if it has specified emergency medical services and transfer agreements, video physician consultation, a physician medical director with onsite oversight and quality-improvement duties, and providers continuously trained in advanced cardiovascular and pediatric life support and capable of providing initial emergency treatment until transport arrives. Hospitals relying on this exception must annually report by November 1 the number of patients with nonpsychiatric or substance-abuse complaints or diagnoses, the number transferred by emergency medical services for emergency treatment, and total psychiatric emergency department evaluations to the specified legislative committees and the Behavioral Health Commission.

The bill establishes licensing requirements for hospitals that provide emergency services. For licenses issued or renewed on or after January 1, 2027, covered hospitals must maintain at least 30 inpatient beds and 15 emergency-department beds and fully comply with the federal Emergency Treatment and Active Labor Act of 1986 (EMTALA) and its implementing regulations, regardless of whether they accept Medicare remuneration.

The requirements do not apply to off-site campuses of a main hospital, federally designated critical access hospitals, rural hospitals as defined by R.S. 40:1189.3, physician-owned hospitals that do not provide 24-hour emergency medical services, or hospitals owned or operated by a Louisiana city, parish, or other political subdivision. The provision is effective August 1, 2026.

The Illinois Police Training Act has been amended to introduce new training requirements for law enforcement officers focused on the identification and interaction with individuals with epilepsy. The Illinois Law Enforcement Training Standards Board is responsible for developing or approving a course that adheres to best practice guidelines from the Centers for Disease Control and Prevention. This training must be implemented within two years of the effective date of the amendment.

All law enforcement officers are now required to complete this training every three years to ensure they are equipped to effectively engage with individuals who have epilepsy. The amendments highlight the necessity of consulting with the Department of Public Health and the Department of Human Services to keep the training curriculum relevant and effective.

These changes are expected to affect various sectors, including law enforcement training, public health, and disability services, as they will need to adjust to the new training requirements. This may involve the development of new educational materials and programs to support the implementation of the training.

While the specific financial implications are not detailed, the introduction of these training programs may lead to costs associated with curriculum development, instructor training, and ongoing education for law enforcement personnel.

FULL SUMMARY

The bill creates the Standardized Prior Authorization Act for Illinois-regulated health coverage and specified Medicaid and CHIP coverage, excluding ERISA self-insured plans and workers’ compensation coverage. Health insurance issuers must maintain and publicly post complete, current lists of services requiring prior authorization, applicable restrictions, clinical review criteria, effective and termination dates, and electronic submission options. Criteria must be evidence-based, nationally recognized, flexible for case-specific exceptions, and reviewed at least annually. Issuers must provide at least 60 days’ notice before implementing new or changed requirements, subject to specified exceptions, publish annual approval, denial, and processing-time statistics by June 1, and accept only documentation reasonably necessary for review. Beginning in 2028, issuers must make standardized electronic request systems available; beginning in 2029, pharmacy requests must use NCPDP SCRIPT ePA transactions and providers must use the standardized process.

The bill establishes decision deadlines of five calendar days after receipt of necessary information for standard requests and 24 hours for expedited urgent requests, requires detailed adverse-determination notices and specialty-qualified physician review of physician-requested appeals, and automatically deems services authorized when an issuer misses statutory deadlines or other requirements. Approvals generally remain valid for the lesser of 12 months or the treatment duration determined by the treating professional, with comparable protections for recurring services for chronic conditions. Issuers may not revoke or restrict valid approvals except for specified fraud, safety, availability, legal, or recognized-standard changes, and must pay properly submitted claims for authorized services subject to limited exceptions. Prior approvals from a former insurer must be honored for at least the first 90 days of new coverage, and previously approved services remain protected through the plan year after changes in coverage or criteria. The Department of Insurance receives rulemaking, complaint-investigation, cease-and-desist, correction-plan, and fine authority; fines may reach $2,000 per violation, and the Act creates annual issuer reporting to the Department while providing no private right of action.

The bill also changes Illinois insurance and public-aid provisions. It removes prior authorization for specified substance-use-disorder benefits and, beginning January 1, 2026, prohibits prior authorization for covered outpatient and partial-hospitalization mental-health services and for inpatient mental-health treatment at participating hospitals, with notification and review conditions; the first 72 inpatient hours generally cannot be subject to concurrent review. Mental-health and substance-use utilization review must rely on current generally accepted standards and specified professional criteria, with comparable review expertise, training, interrater-reliability testing with a 90% pass threshold, and parity oversight. Network plans must meet new provider, travel, appointment-wait, and behavioral-health access standards, including 30-minute/30-mile outpatient access in specified metropolitan counties, 60-minute/60-mile standards elsewhere, and 60-minute/60-mile inpatient or residential access statewide; inadequate networks require in-network-level coverage and, beginning January 1, 2026, reimbursement for qualifying travel, lodging, and food. The bill makes conforming changes to the Illinois Insurance Code, Network Adequacy and Transparency Act, and Public Aid Code, repeals the Prior Authorization Reform Act, and takes effect January 1, 2027.

The bill requires each hospital licensed by the Illinois Department of Public Health that provides general medical and surgical services to have at least one licensed physician specializing in emergency medicine staffing its emergency department at all times. The requirement excludes long-term acute care hospitals and rehabilitation hospitals identified in Section 1.3 of the Hospital Emergency Service Act. The Act takes effect upon becoming law.

The bill requires the Department of Public Health to issue an annual Freestanding Emergency Center license to a facility that meets the existing requirements in Section 32.5(a), with two exceptions: the center may be located in a municipality with more than 50,000 inhabitants, and, if operated as a provider-based entity under 42 CFR 413.65, it may describe itself or hold itself out in advertising and marketing as a hospital emergency department.

FULL SUMMARY

The bill adds section 33½ to chapter 276, establishing a right to emergency medical services for any person experiencing an emergency medical condition or who is medically unstable while in direct audio or visual contact with, or custody or control of, a law enforcement or correctional officer. The definitions cover physical, behavioral, substance-use-related, and mental-health conditions; law enforcement and correctional personnel and agencies; and licensed medical personnel.

Except for a specified exception, an officer must immediately request emergency medical services when a person in the officer’s custody or control or in direct audio or visual contact communicates, or the officer reasonably observes, that the person has an emergency medical condition or is medically unstable. The officer is excused from making the request only when the officer reasonably determines that neither condition exists and knows the person was evaluated by a medical professional within the preceding 24 hours and released after being determined not to have either condition.

When medical personnel and law enforcement or correctional officers are simultaneously involved, the officer must immediately allow medical personnel to begin treating a person in the officer’s custody or control who communicates, or is reasonably observed to have, an emergency medical condition or to be medically unstable.

The bill repeals Minnesota’s hospital construction moratorium by repealing Minnesota Statutes, section 144.551, subdivisions 1, 1a, 2, 3, and 4. It preserves any conditions attached to hospital construction moratorium exemptions granted under the repealed section, so those existing conditions remain in effect.

Conforming changes remove hospital-moratorium references from section 62J.17, subdivision 3, while retaining the nursing-home exemption. They also eliminate the health commissioner’s authority to inspect hospitals or hospital systems for continued compliance with conditions attached to a former moratorium exception and remove the requirement that hospital-bed licenses issued under such an exception be denied renewal when those conditions are not satisfied.

The bill also repeals the public-interest review process in section 144.552, the alternative hospital-approval process in section 144.553, and the county hospital-capacity limitation in section 376.08, subdivision 3. Existing hospital licensing, inspection, and enforcement provisions not specifically changed by these repeals remain in place.

Beginning in the 2026-27 school year, Wisconsin schools and charter schools will be required to implement a cardiac emergency response plan (CERP) for emergencies occurring on school property and during athletic events. The CERP must include essential components such as a designated response team, a plan for activation, distribution of the plan, and guidelines for the placement and maintenance of automated external defibrillators (AEDs).

For athletic events, the CERP will ensure that coaches and athletic trainers are equipped to handle sudden cardiac arrest incidents, which includes requirements for AED accessibility and CPR certification for coaches.

To support the implementation of these plans, the Office of School Safety in the Department of Justice may provide grants to schools, with amounts varying based on the grade levels offered. The maximum grant amounts are $8,000 for high schools, $4,000 for schools serving grades 6 to 8, and $2,000 for schools with grades K-5.

This legislation aims to improve safety measures in educational environments and may influence related industries, including emergency medical services, CPR and AED training providers, and AED manufacturers.

FULL SUMMARY

The bill amends chapter 276 of the Massachusetts General Laws by adding section 33½, establishing rights to emergency medical services for persons experiencing an emergency medical condition or who are medically unstable while in direct audio or visual contact with, or under the custody or control of, a law enforcement or correctional officer. It defines those conditions and the relevant law enforcement agencies, officers, correctional officers and agencies, and medical personnel.

Except for a specified exception, officers must immediately request emergency medical services when a person in their custody or control, or otherwise in direct audio or visual contact with them, communicates or is reasonably observed to be experiencing an emergency medical condition or to be medically unstable. An officer need not make the request if the officer reasonably determines neither condition exists and knows the person was examined by a medical professional within the previous 24 hours, released, and determined not to have either condition.

When medical personnel and law enforcement or correctional officers are simultaneously involved, officers must immediately allow medical personnel to begin treatment of a person in their custody or control who communicates, or is reasonably observed, to have an emergency medical condition or to be medically unstable.

FULL SUMMARY

The bill establishes statewide pediatric-readiness requirements for hospital emergency departments, including satellite emergency departments. Each department must develop and implement evidence-based pediatric-care policies covering triage, vital signs, kilogram weight recording, medication dosing, pediatric equipment, and age-appropriate care. Departments must provide annual staff training, including role-appropriate clinical simulation and pediatric emergency drills at least every six months, and designate a qualified physician, physician assistant, registered nurse, or advanced practice registered nurse as a pediatric emergency care coordinator responsible for implementing policies, ensuring compliance with standards, and coordinating training.

Each emergency department must conduct the National Pediatric Readiness Assessment according to the National Pediatric Readiness Project’s schedule and submit results to the Bureau of Emergency Medical Services by December 31 of the assessment year. The bureau must collect overall assessment scores, may publish aggregate data, and must adopt rules establishing minimum pediatric emergency-care standards for equipment and supplies, staff training, quality assurance, and assessment-result reporting. A general acute hospital may voluntarily conduct the project’s Open Assessment in a year when the required assessment is not conducted.

For fiscal year 2027, the bill reallocates $278,000 within the Department of Public Safety and provides $278,000 in General Fund pass-through grant funding for pediatric readiness, with legislative intent that the department make a direct award to the Utah Pediatric Trauma Network. The bill takes effect May 6, 2026.

Beginning in the 2026-27 school year, Wisconsin schools and charter schools will be required to implement a cardiac emergency response plan (CERP) for emergencies occurring on school property and during school-sponsored athletic events. This plan must include the establishment of a cardiac emergency response team, procedures for activating the team during a cardiac arrest, and coordination with local emergency medical services.

For athletic events, the CERP will ensure that automated external defibrillators (AEDs) are clearly marked and accessible, and that athletic coaches are certified in CPR and AED usage. Ongoing training for school personnel in first aid, CPR, and AED use will also be mandated.

To support the implementation of these requirements, the Office of School Safety in the Department of Justice may provide grants starting in the 2026-27 school year. Grant amounts will vary based on the grade levels offered by the schools, with a maximum of $8,000 for high schools, $4,000 for schools serving grades 6 to 8, and $2,000 for schools serving grades K-5.

The legislation will impact educational institutions, emergency medical services, and training organizations that provide CPR and AED certification. While schools may incur costs related to training, equipment procurement, and compliance, the availability of grants may help offset some of these expenses.

FULL SUMMARY

The bill adds a public-records exemption for the home addresses, personal telephone numbers, and dates of birth of current emergency department physicians, and for the names, home addresses, personal telephone numbers, dates of birth, and places of employment of their spouses and children younger than 26. It also exempts the names and locations of schools and day-care facilities attended by those children. An emergency department physician is a physician licensed under chapter 458 or 459 whose duties are performed in a hospital emergency department licensed under chapter 395.

The exemption applies to information held by an agency before, on, or after July 1, 2026. A custodial agency other than the physician’s employer must maintain the exemption only after the eligible individual submits a written, notarized request stating under oath the statutory basis for and confirming eligibility for the exemption. The individual must withdraw the request when the exemption no longer applies; upon receiving a compliant request, the agency must maintain the protected status until the qualifying conditions cease.

The exemption is subject to the Open Government Sunset Review Act and will be repealed on October 2, 2031, unless the Legislature reviews and reenacts it. The act takes effect July 1, 2026.

FULL SUMMARY

The bill adds requirements for every hospital emergency department to establish evidence-based pediatric-care policies covering triage, vital signs, weight in kilograms, medication dosing, and pediatric instruments. Hospitals must provide annual training on those policies, including clinical-simulation training on pediatric instruments and annual emergency drills. Each department must designate a qualified pediatric emergency care coordinator—a physician, physician assistant, nurse, or paramedic—responsible for implementing and enforcing the policies, and must conduct the National Pediatric Readiness Assessment according to the National Pediatric Readiness Project’s schedule. A hospital may conduct the Project’s Open Assessment in years when the full assessment is not conducted.

The Agency for Health Care Administration must incorporate into comprehensive emergency-management-plan rules provisions addressing the needs of pediatric and neonatal patients. In consultation with the Florida Emergency Medical Services for Children State Partnership Program, the agency must also adopt rules establishing minimum standards for pediatric care in hospital emergency departments, including the availability of and immediate access to pediatric-specific equipment and supplies. The bill redesignates existing subsections of section 395.1055 to accommodate the new pediatric-care rulemaking provision.

The agency must collect each hospital emergency department’s overall National Pediatric Readiness Assessment score from the Florida Emergency Medical Services for Children State Partnership Program by December 31, 2026, and by December 31 of each subsequent assessment year. Beginning April 1, 2027, and annually after each assessment year, it must publish each department’s score, compare it with the national average when available, and publish no more than one score per hospital per year along with a comparison to the hospital’s most recently published score. The act takes effect July 1, 2026.

FULL SUMMARY

Establishes an Emergency Medicine Study Committee to examine Arizona’s emergency medical services system, including delivery obstacles, statewide capacity, rural and urban adequacy, uncompensated-care effects, provider stability, and information from patients, providers, and other stakeholders. The committee may hold public hearings, conduct fact-finding tours, request data from the Department of Health Services, and take testimony; the Legislature and department must provide staff and support.

The committee will comprise six legislators, the Department of Health Services director or designee, two emergency-department operators representing counties below and above 500,000 residents, three licensed physicians with specified emergency-medicine or EMS roles, one licensed registered nurse or nurse practitioner working in emergency medicine, and two prehospital emergency medical service providers representing counties below and above 500,000 residents. Legislative appointments are made by the House Speaker and Senate President, with specified partisan-balance requirements. Members receive no compensation but may be reimbursed for expenses under existing law.

On or before December 31, 2026, and annually thereafter, the committee must report its findings and recommendations to the governor, Senate president, and House speaker, and provide a copy to the secretary of state. The provision establishing the committee is repealed after June 30, 2029.

FULL SUMMARY

The bill establishes a statewide air medical services program within the Department of Health’s Emergency Medical Services and Injury Prevention System Branch. The program is responsible for statewide governance, coordination, oversight, quality improvement, and disaster readiness for emergency aeromedical and interfacility air medical transport. It creates three permanent, recurring positions exempt from chapter 76: a physician state air medical director, a state air medical program manager, and an air medical coordinator, with specified clinical, administrative, coordination, data, compliance, and performance-improvement duties.

The program may provide clinical governance and medical direction; develop policies, procedures, and protocols consistent with nationally recognized standards; coordinate transports across counties; oversee provider participation in data-based quality improvement; support disaster preparedness, response, and recovery; and coordinate with emergency medical services agencies, health care facilities, emergency management agencies, and other partners. As a licensure condition, all air medical providers operating in Hawaii must participate in department-required statewide coordination, data reporting, and quality-improvement activities. The department may establish advisory or quality-improvement committees and adopt implementing rules.

The department must establish and assess reasonable, nonrefundable annual licensure and accreditation fees sufficient to cover program administration, oversight, licensure and compliance activities, coordination, quality improvement, data functions, and emergency-management integration. Fee proceeds must be deposited in the Emergency Medical Services Special Fund and used solely to administer and support the statewide program, its staff, and related emergency-management coordination. The bill correspondingly directs fees remitted under the new program section to those purposes and renumbers the existing fund-distribution provision, while retaining the $3.5 million annual county distribution and the remaining distribution for the department’s emergency medical services system. The Act takes effect July 1, 3000.

The bill adds a provision requiring the Department of Public Health to issue an annual Freestanding Emergency Center license to a facility that satisfies the existing requirements in subsection (a). The facility may be located in a municipality with more than 50,000 inhabitants. If operated as a provider-based entity under 42 CFR 413.65, it may describe itself or hold itself out to the public as a hospital emergency department in advertising and marketing activities.

FULL SUMMARY

The bill establishes the Emergency Medical Care Clarity Act for Mississippi. Beginning July 1, 2026, hospitals—including licensed hospitals with emergency departments, freestanding emergency departments, and facilities holding themselves out as providing emergency care—must provide an appropriate medical screening examination and emergency medical services to anyone seeking emergency examination or treatment, or on whose behalf it is requested. If an emergency medical condition is identified, the hospital and its medical staff must provide stabilizing treatment within their capability and capacity, without delay or denial based on inability to pay, lack of insurance or public benefits, citizenship or immigration status, pregnancy outcome or status, or personal, institutional, or religious beliefs or policies. Medically necessary stabilizing interventions may include procedures that could result in pregnancy termination when, in the physician’s reasonable medical judgment, they are necessary to prevent death or serious impairment of a major bodily function; such treatment may be conditioned only on the consent of the patient or legal representative.

The bill defines emergency medical conditions to include serious acute conditions and specified pregnancy-related conditions, including active labor, ectopic pregnancy, threatened or incomplete miscarriage, pregnancy-loss complications, preterm premature rupture of membranes, placental abnormalities, emergent hypertensive disorders such as preeclampsia, risks to future fertility, and situations in which transfer cannot safely occur. An unstabilized patient may be transferred only if the transferring hospital provides available risk-minimizing treatment; the receiving hospital has capacity, qualified personnel, and agrees to accept the patient; relevant records are sent; qualified personnel and appropriate transportation and life support are used; the patient or representative requests the transfer in writing after being informed of its risks; and a physician certifies that the expected medical benefits at the receiving hospital outweigh the increased transfer risks.

The Attorney General and State Department of Health may investigate violations and bring civil actions seeking injunctions, penalties of up to $50,000 per violation, and, for repeat or gross violations, corrective-action orders, license suspension, or Medicaid exclusion. Individuals harmed by violations may sue for compensatory and punitive damages, equitable relief, and reasonable attorney’s fees and costs; hospitals and providers may not invoke religious or moral objections or federal conscience protections as immunity when those objections result in denial of stabilizing emergency care. Hospitals may not penalize providers who deliver stabilizing care consistent with medical standards, employees are protected from retaliation for reporting violations, and hospitals with specialized capabilities must accept appropriate transfers when capacity exists.

The bill adds two new sections to the West Virginia Code requiring hospitals to develop protocols for trauma-informed care for patients who have experienced a miscarriage, abuse, neglect, or other stressful events. The protocols must include training and continuing education on trauma-informed care; hospitals may consult licensed mental health professionals, medical associations, and patient advocacy groups when developing the training.

Hospitals must also compile patient resources, including contact information for local or statewide mental-health services, guidance on grief and emotional recovery, crisis-support hotlines, and information about peer or community support groups.

For patients who have experienced a miscarriage, each hospital must develop and implement a “Butterfly Protocol.” It must use a discreet visual symbol, such as a small butterfly, in the patient’s chart or electronic medical record to alert staff, and must train staff on the symbol’s meaning, how to identify it in records, and how to provide trauma-informed care to patients whose records contain it.

FULL SUMMARY

The bill adds a new Hawaii public-school framework allowing volunteer employees and agents, including school health assistants, to administer emergency epinephrine, glucagon, seizure-rescue medication, and inhalers, and to administer or assist with insulin and blood-glucose monitoring. For medication prescribed to a specific student, the parent or guardian must provide written authorization, medical orders from an authorized prescriber, and the prescribed medication and necessary supplies. Permission applies for one school year and must be renewed annually; schools may store supplies in a secure but accessible location, and volunteers must be trained by specified licensed health professionals. The Department of Education must permit its employees and agents to volunteer for these functions, including emergency treatment for anaphylaxis, diabetes, seizures, and asthma.

The new framework requires written liability notices to parents or guardians, a signed acknowledgment and indemnification by the parent or guardian, and immunity from civil or criminal liability for schools, volunteers, trainers, prescribers, and dispensing pharmacies acting in compliance, except for gross negligence, wilful and wanton misconduct, or intentional misconduct. It defines covered epinephrine, glucagon, inhalers, bronchodilators, and seizure-rescue medications broadly enough to include prescription delivery devices such as auto-injectors, nasal sprays, nebulizers, and other premeasured-dose devices.

The bill separately revises the existing student self-administration provisions by removing their volunteer emergency-administration and diabetes-assistance provisions, while retaining authorization for students to self-administer medication and conduct their own blood-glucose monitoring. It expands the medical certification options to include other qualified health care providers, specifies certification concerning a student's ability to manage diabetes and carry necessary supplies, and permits students to carry any medication and devices needed for authorized self-administration, subject to confiscation for dosage violations or danger to others. The revised liability protection applies to any person acting in compliance with the self-administration section, subject to the same misconduct exceptions. The Act takes effect upon approval.

Requires every Missouri hospital with an emergency department to have at least one physician physically on site and on duty, responsible for the emergency department, whenever the department is open. The requirement would be codified as new Section 197.062, RSMo.

FULL SUMMARY

The bill establishes a statewide time-sensitive emergencies data repository covering trauma, cardiac events—including heart attack and sudden cardiac arrest—and stroke. The Department of Health must establish it by January 1, 2031, define relevant data elements by rule, and require quarterly submissions in an approved format from trauma-care and rehabilitative providers, specialized cardiac-care hospitals, and specialized stroke-care hospitals. Until the repository is established, the department must maintain the existing trauma registry. The department must validate repository data, implement continuous quality-improvement processes, coordinate with existing data sources and state and national organizations, enter data-sharing agreements as needed, and provide technical assistance to ambulance and aid services, hospitals—including critical access hospitals—and regional emergency-care partners.

The bill requires the department, beginning July 1, 2033, to publish annual aggregate reports analyzing statewide progress in care quality and patient outcomes; the first report must also recommend whether on-site verification of hospitals’ adherence to cardiac and stroke systems of care is needed. It requires a statewide electronic emergency medical services data system and rules requiring licensed ambulance and aid services to report patient-encounter data, including suspected drug overdoses for referral to peer, navigation, outreach, treatment, and other support services. Regional emergency medical services and trauma-care quality-assurance programs must evaluate emergency cardiac and stroke care in addition to trauma care. The department must use repository and EMS-system data for performance oversight, quarterly reporting to specified advisory committees, recommendations to the statewide steering committee, provider feedback, system standards and education, and dissemination of improvement interventions.

The bill authorizes the department to respond to data requests for special studies, public-health activities, and analysis subject to patient and quality-assurance confidentiality requirements; individual patient, provider, and facility outcome-identification data are confidential, exempt from chapter 42.56 RCW, and generally not discoverable or admissible. The department must competitively procure a single entity to develop and administer the repository, and, within specific appropriations, assist critical access and rural hospitals and rural prehospital services with data platforms, equipment, and training and conduct public education on heart-attack and stroke symptoms and the benefits of immediately calling 911. A “time-sensitive emergency” is defined as a condition requiring rapid assessment, intervention, and coordinated transport to improve outcomes and reduce death or permanent disability.

Beginning January 1, 2031, hospitals voluntarily participating in the cardiac and stroke care system must submit the applicable data to the statewide repository, in addition to their existing quality-improvement and performance-data participation requirements.

The bill requires the State Board of Medical Examiners to include one continuing-medical-education credit on communication with and treatment of persons who are deaf or hard of hearing within the credits required for each licensed physician’s biennial registration. The training must meet the requirements for training programs under subsection b. of section 1 of P.L.2021, c.79, and remains subject to the existing provisions governing continuing-medical-education requirements.

It directs the Division of Deaf and Hard of Hearing in the Department of Human Services to create a dedicated training and outreach unit to develop and administer training for individuals working in the emergency departments of general hospitals. Each such emergency department, in consultation with the Division, must develop a protocol on proper communication and treatment for employees who may interact with deaf or hard-of-hearing individuals during their employment.

The requirements take effect 90 days after enactment.

The bill requires every Alabama hospital with an emergency department, regardless of classification, to have at least one physician on duty and physically present who is primarily responsible for the emergency department whenever it is open. Compliance is made a condition of hospital licensing and license renewal under Article 2 of Chapter 21 of Title 22, Code of Alabama 1975. The requirement takes effect October 1, 2026.