The bill establishes a new prohibition in South Dakota law that bars requiring COVID-19 vaccination as a condition for employment, enrollment, or receipt of a benefit or service. It applies broadly to employers, educational institutions, state agencies, political subdivisions, and other persons, and includes an explicit “notwithstanding any other provision of law” clause.

A violation of the new prohibition is classified as a Class 2 misdemeanor, creating criminal penalty exposure for covered entities or individuals who impose COVID-19 vaccination requirements under the specified circumstances.

It creates this new rule by adding a new section to chapter 34-22; no other statutory changes are shown in the provided text.

FULL SUMMARY

The bill establishes/implements: (1) changes to how the Illinois Health Facilities Planning Act (IHFPA) handles public notice/hearing and related exemption processing for certain transactions and service discontinuations; and (2) additions to the Illinois Antitrust Act creating (and then scheduling repeal of) a statutory notice-and-enforcement framework for “covered transactions” involving health care facilities/provider organizations, including authority for the Attorney General to investigate, seek injunctions, and assess civil penalties.

The bill also amends: (1) IHFPA Section 8.5 by altering a scheduled inoperability date for changes made by a prior amendatory act and, within Section 8.5, retaining the related procedural requirements for exemption issuance (including notice, posting/sending requirements, and certification/statement timing); and (2) the Illinois Antitrust Act Sections 7.2a and 13, including adding or modifying the definitions and notice obligations tied to covered transactions, plus the civil penalty, injunctive relief, and repeal provisions.

It further amends the State Finance Act by changing the Antitrust Enforcement Fund provision (Section 5.1007), which repeals on a specified date that aligns with the scheduled repeal of the Antitrust Act provisions.

A key operational effective date is explicitly stated as January 1, 2027.

The bill directs the Secretary of Health and Human Resources to convene a work group to study the impact of private equity on health care.

The work group is required to (i) analyze current health care facility ownership transparency requirements in Virginia and compare them to requirements in other states and federal requirements, (ii) identify risks and benefits to the public of greater ownership transparency of health care facilities, (iii) analyze risks and benefits of private equity acquisitions of health care facilities, and (iv) develop policy recommendations to promote greater transparency in health care facility ownership within Virginia.

The work group must include relevant stakeholders, specifically representatives from the Virginia Association of Health Plans, the Virginia Hospital and Healthcare Association, the Medical Society of Virginia, the Virginia Health Care Association, and other stakeholders as deemed appropriate. The Secretary must submit a report with the work 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 establishes a new statutory rule making certain contractual restrictions on physician associates unenforceable in New Hampshire. It adds a new RSA 328-D:20 providing that any contract or agreement that creates or establishes the terms of a partnership, employment, or other professional relationship with a physician associate licensed to practice medicine in the state—specifically including restrictions on the right to practice in any geographic area for any period after the relationship ends—is void and unenforceable with respect to that restriction.

The provision includes a severability-style carveout: rendering a covered restriction void or unenforceable does not void or make unenforceable the remaining provisions of the same contract or agreement. The new requirements apply only to new contracts and renewals of contracts entered into on or after the act’s effective date.

The act takes effect 60 days after passage, with an approved date of May 8, 2026 and an effective date of July 7, 2026.

FULL SUMMARY

The bill establishes a new New York Labor Law prohibition on employers requiring or accepting non-compete agreements from “covered individuals” and from “health related professionals,” making any such non-compete sought, required, demanded, or accepted after the law’s effective date null, void, and unenforceable.

It adds Labor Law § 191-d defining (1) “non-compete agreement” as any clause restricting a covered individual from obtaining employment after conclusion of employment; (2) “covered individual” as a person (excluding only “highly compensated individuals”) who performs work for another person on terms creating economic dependence and an obligation to perform duties; (3) “highly compensated individual” as an individual paid average annualized cash compensation of at least $500,000 (based on income on three most recent W-2s/K-1s, adjusted annually beginning in 2027 using the NY CPI-U with a 2026 base year); and (4) “health related professional” as enumerated licensed health professions (including physicians and multiple other specified categories) under listed Education Law articles. The bill also clarifies that the prohibition does not restrict agreements that set fixed terms/exclusivity during employment, prohibit trade-secret disclosure, prohibit disclosure of confidential/proprietary client information, or prohibit client solicitation—so long as those agreements do not otherwise restrict competition in violation of the section.

The bill creates a private enforcement mechanism: covered individuals and health related professionals may sue employers (and alleged violators) in court within two years of the later of signing, learning of the non-compete, termination of the relationship, or an employer step to enforce it. Courts may void the non-compete and order relief including injunctions, liquidated damages, and awards of lost compensation, compensatory damages, and reasonable attorneys’ fees and costs. Liquidated damages are capped at no more than $10,000 per covered individual or health related professional, and the court is directed to award liquidated damages to every covered person affected in addition to other remedies. The bill further addresses enforcement boundaries by requiring any choice-of-law/venue provision intended to avoid or limit these requirements to be unenforceable for covered individuals who were NY residents or worked in NY (including certain remote workers) for at least 30 days immediately before ceasing employment. It requires employers to post employee notice of these rights under existing Labor Law posting provisions.

The bill allows non-compete agreements (or similar covenants) in the sale of goodwill of a business and in certain ownership-interest sale/disposition contexts when specified ownership thresholds are met (e.g., at least 15% ownership by the selling partner/member or by an acquiring owner/entity). For agreements permitted/enforceable under the section, it sets common-law enforceability requirements (reasonableness in time/geography/scope; no undue hardship; no harm to the public; protection of legitimate business interests; and restrictions no broader than necessary), limits any time restriction to no more than one year, and requires that salary be paid during enforcement. It also adds a separate Labor Law § 45 requiring the Department of Labor to develop an employee notice of rights under § 191-d, provide it to employers for distribution, and post it on the Department’s website.

Effective date provisions make the main change applicable 30 days after enactment to contracts entered into or modified on or after that date, with no retroactive effect; the notice-related section (§ 2) takes effect 180 days after enactment, and the Department/implementation-related rule or regulation changes are authorized to be made and completed by the effective date.

FULL SUMMARY

The act creates a new Vermont statutory chapter, “Clinical Decision Making,” in Title 18, establishing limits on how certain investors can influence clinical decisions at Vermont health care facilities. It defines key terms including health care facility/provider/services, health care staffing company, hedge fund, private equity group, ownership/investment interest, provider organization, and significant equity investor. The framework targets private equity groups and hedge funds that have ownership/investment or controlling interests (including through certain thresholds and arrangements) in health care facilities or management services organizations.

A private equity group or hedge fund involved with a health care facility doing business in Vermont is prohibited from interfering with health care providers’ clinical judgment, including decisions on appropriate diagnostic tests, referrals/consultations, patient care plans and available treatment options, and limits on provider workload (number of patients/hours). It is also prohibited (and cannot be delegated the power) from exercising control over or setting clinical standards/policies and staffing levels, controlling patient medical record content, hiring/firing health care personnel based on clinical competency/proficiency, setting parameters for third-party payer contracting, setting the facility’s prices/rates for providers’ services, setting clinical competency/proficiency parameters for provider-to-provider contracting, making coding/billing decisions, and selecting/approving medical equipment and supplies. The act states facility organizational form does not change applicability and permits unlicensed entities to provide nonclinical management/administrative/business services only if a licensed health care provider retains ultimate responsibility/approval and there is no de facto control affecting clinical operations. A health care provider aggrieved by violations may sue in Superior Court for equitable relief, actual damages, costs, and attorney’s fees.

The act adds an ownership and control reporting regime to the Green Mountain Care Board. By March 1, 2027, each health care facility and management services organization must either (1) submit specified ownership/control information if one or more private equity groups or hedge funds held an ownership/investment interest as of June 1, 2026, or (2) submit an attestation that there is no such private equity/hedge fund ownership/investment as of that date. After March 1, 2027, reporting is required when a private equity group or hedge fund takes on an unreported ownership/investment interest or when there is a modification to the existing interest. The report contents include the names/addresses/business identifiers of relevant persons (owners, controlling interest holders, management services orgs, and significant equity investors), an organizational chart, and the facility/organization’s most recent fiscal year profit/loss statement and balance sheet. Exemptions apply for nursing homes, health care staffing companies, federally qualified health centers, and entities whose Vermont health care services are delivered exclusively through telehealth (including telemedicine/store-and-forward and remote patient monitoring). Information is generally public, but certain personal identifiers (e.g., provider taxpayer ID that is also a Social Security number and other nonbusiness contact/address info) and submitted financial statements are kept confidential under the Public Records Act, with disclosures to the Office of the Health Care Advocate.

The act imposes enforcement and transparency requirements: knowingly failing to report required information triggers civil penalties capped at $50 per day (not exceeding $10,000 per year), and making a material misrepresentation triggers civil penalties up to $25,000 per material misrepresentation; the Attorney General may sue in Superior Court to collect penalties and seek injunctive relief. The Green Mountain Care Board must post on its website a public report on ownership information collected under the chapter on or before July 1, 2027 and every two years thereafter, covering the number of reporting entities (by business structure), entities with ownership/controlling interests, changes in ownership/control, changes in tax identification numbers, and relevant affiliate/subsidiary/management entities information as applicable. The Board may share reported information with specified state officials/agencies to reduce duplication or facilitate oversight/enforcement, including sharing confidential tax-identification information subject to confidentiality agreements. The act takes effect July 1, 2026.

FULL SUMMARY

The bill establishes a new Iowa chapter (135S) creating protections for medical practitioners and health care institutions related to exercising “conscience,” reporting suspected violations (whistleblower activity), and engaging in speech or association protected by the U.S. Constitution’s First Amendment. It defines key terms—conscience, discrimination, health care institution/service, medical practitioner, and “participate in a health care service”—with “conscience” tailored to both individuals and institutions (including governance documents such as bylaws, policies, or religious/ethical guidelines). “Discrimination” is defined to cover adverse actions or threats tied to refusal to participate in a health care service based on conscience, but it expressly excludes certain insurance/coverage transactions and an institution’s good-faith efforts to accommodate conscience.

The bill grants medical practitioners and health care institutions a right not to participate in or pay for a health care service that violates their conscience, and prohibits discrimination against them for exercising that right. It requires that a medical practitioner inform the practitioner’s employer of the nature of the conscience-based objection, while clarifying that this notice does not waive other duties to participate in services that do not violate conscience. The conscience right includes an exception allowing religion-based entities that publicly hold themselves out as religion-based and implement religious beliefs internally (through governing documents and operating policies) to make employment, staffing, contracting, and admitting-privilege decisions consistent with their religious beliefs. It also limits legal exposure by providing immunity: a practitioner or institution is not civilly, criminally, or administratively liable for good-faith exercise of conscience, including vicarious immunity for a health care institution for the good-faith conscience exercise of covered practitioners.

The bill adds whistleblower protections: it prohibits discrimination against a practitioner or institution for providing information about suspected violations of the chapter to specified enforcement and oversight entities (including the attorney general and federal bodies), for testifying, or for assisting in proceedings under the chapter. It also prohibits discrimination based on disclosure the disclosing party reasonably believes evidences (i) a violation of law/rule, (ii) violation of standards of care or ethical guidelines, or (iii) gross mismanagement/waste/abuse of authority, dangerous treatment practices, or a substantial and specific danger to public health or safety. The chapter requires that these protections do not exempt compliance with federal HIPAA and other confidentiality/privacy requirements.

The bill creates free speech protections tied to licensing/credentialing. It restricts state departments/boards and other licensing/certifying entities from reprimanding, sanctioning, or threatening license/revocation when a practitioner or institution engages in speech, expressive activity, or association protected by the First Amendment, unless the state proves by clear and convincing evidence the speech/association was the direct cause of physical harm to a person in a practitioner-client/patient relationship within the three years preceding the harm incident. It also establishes procedural notice: within 21 days after receipt of a potentially revocation-related complaint, the regulator must provide a copy of the complaint; failure triggers an administrative penalty of $500 per day of noncompliance. The bill prohibits the state from requiring or obtaining a certification/credential from entities that revoke or refuse credentials to a compliant provider who did not provide disqualifying medical advice/treatment, and it creates a civil enforcement mechanism for unlawful interference with conscience, whistleblower rights, or free speech protections, including potential injunctive relief, monetary damages, and attorney fees, while adding cumulative-remedy language and an explicit bar on civil actions against a person who declines to provide a covered health care service due to conscience under the chapter.

This legislation significantly alters employment and contractual practices related to non-compete agreements across various industries, including healthcare and professional services. Starting July 1, 2025, restrictions on employees' or contractors' ability to practice their profession after the end of their employment or contractual relationship are declared void and unenforceable, unless explicitly specified otherwise in certain sections.

The bill amends multiple sections of the Tennessee Code Annotated to remove or modify references that previously allowed the enforceability of non-compete restrictions. As a result, the changes broadly expand the rights of employees and contractors by limiting the enforceability of non-compete clauses.

These modifications will apply to all contracts entered into or amended on or after July 1, 2025. This shift is likely to reduce the enforceability of non-compete agreements, potentially impacting businesses that rely on such provisions to protect their interests.

Overall, the legislation aims to enhance individual mobility and restrict the use of non-compete restrictions, thereby reshaping contractual practices within affected industries.

The bill establishes a general rule that, except as otherwise provided in Tennessee Code Annotated (TCA) § 63-6-204(f)(2), any restriction on an employee’s or contractor’s right to practice the person’s profession after the termination or conclusion of employment or a contractual relationship is void and unenforceable in Tennessee.

It also repeals TCA § 63-1-148 by deleting the entire section.

In addition, it removes cross-references to TCA § 63-1-148 (or any successor) from multiple restrictive-covenant provisions relating to (1) TCA § 63-6-204(f)(2)(B), (2) TCA § 63-6-204(g)(2), (3) TCA § 63-6-204(g)(3) (changing “Notwithstanding § 63-1-148 …, in” to simply “In”), (4) TCA § 68-11-205(c)(2) and (5) TCA § 68-11-205(c)(3) (similarly removing “Notwithstanding § 63-1-148 …,” language), and (6) TCA § 68-11-205(f)(2) (deleting a “provided, such restriction complies with 63-1-148” condition). These changes align other parts of the covenants-not-to-compete framework with the repeal of § 63-1-148.

The act takes effect July 1, 2025, applies to contracts entered into or amended on or after that date, and includes an express statement that the public welfare requires the effective date.

FULL SUMMARY

The bill amends and reenacts Virginia Code § 40.1-28.7:8, which prohibits employers from entering into, enforcing, or threatening to enforce noncompete covenants against (1) low-wage employees and (2) health care professionals, and provides enforcement mechanisms including civil actions, remedies, and civil penalties.

Operative changes in the reenacted section (as reflected in the provided text) include: (a) clarifying definitions, including that “health care professional” covers persons licensed/registered/certified by specified boards; and that “low-wage employee” includes employees meeting a low-earnings threshold or overtime-eligibility test, and further includes interns/students/apprentices/trainees and certain independent contractors compensated below a defined median hourly wage threshold, while excluding employees whose pay is predominantly derived from sales commissions/incentives/bonuses; (b) confirming that employers may still use nondisclosure agreements to protect trade secrets and proprietary/confidential information, and may use certain restrictive covenants for health care professionals in the context of a sale of a business if reasonably limited in scope, duration, and geography; (c) authorizing employer recruitment cost-repayment provisions and limiting-scope customer non-solicitation provisions for health care professionals, provided they meet specified conditions and construction rules (and do not preclude disclosures to patients under stated circumstances).

Enforcement and remedies remain available as follows: a covered individual may bring a civil action to void an unlawful noncompete and obtain appropriate relief (including injunctions, liquidated damages, lost compensation/damages, and reasonable attorney fees and costs), subject to a two-year deadline measured from the later of several trigger dates (signature, learning, termination, or an enforcement step). The court also has jurisdiction to award relief and the employer is prohibited from retaliating against the covered individual for bringing suit.

The bill sets civil penalties and additional compliance requirements: the Commissioner may assess a $10,000 civil penalty per violation for employer violations determined by the Commissioner; employers must post a copy of the section or a Department-approved summary at the workplace location where other required employee notices are posted, and failure to do so triggers Department-issued enforcement. The bill also includes a transitional rule stating that it does not invalidate, alter, or affect contracts, covenants, or agreements entered into or renewed prior to July 1, 2026.

FULL SUMMARY

HB605 creates Alabama’s “Rural Health Antitrust Immunity Act,” establishing a state certification and active supervision system administered by the State Health Planning and Development Agency (SHPDA) to permit regulated collaboration among rural healthcare providers and related entities and individuals. The act sets a state policy to preserve rural healthcare access and quality by substituting regulated collaboration and coordination for “unfettered competition” in rural healthcare markets when reasonably necessary to further the act’s purposes.

Under the framework, entities and individuals may engage in specified collaborative activities (including joint purchasing/contracting; shared clinical/administrative/support services; coordinated staffing; joint quality initiatives; shared technology; joint negotiations with payors/suppliers/vendors; coordinated service line development; and shared facilities/equipment/infrastructure) only if approved via a SHPDA-issued certificate and subject to the act’s limitations. The act expressly prohibits certain arrangements from being treated as allowed activities for approval purposes—specifically excluding (as categories not included and expressly prohibited from approval) joint negotiations with certain health benefit plans/insurers and other enumerated plan administrators/administrators, and requires that the prohibited plan-related parties are not included in the approval pathway.

To obtain approval, applicants must apply before engaging and receive a valid certificate from SHPDA acting through its Executive Director. The application must describe the parties; the nature and scope; anticipated effects including any expected impact on competition; and other requested information, and must certify the engagement is in good faith and reasonably necessary to further the act’s policy. SHPDA may issue a certificate only if it determines the activities are reasonably necessary to further the act and that benefits outweigh foreseeable anticompetitive effects; in making this determination, SHPDA is directed to consider factors including rural hospital/care quality; continued availability of nearby facilities; cost efficiencies; avoidance of duplication of rural resources; health outcome improvements; access for medically underserved populations and their likely benefit; payors’ ability to negotiate appropriate arrangements; competition effects; quality/availability/price; and whether alternatives could achieve the same or greater public health benefits with fewer anticompetitive effects.

The act places certificates under executive-level approval and ongoing oversight: certificates do not become effective until reviewed and approved in writing by the Governor (or designee), who may approve in whole/part, disapprove, return for further consideration, and impose conditions. Certificates have a three-year validity term with renewable three-year increments upon renewal applications demonstrating continued good-faith continuation and continued reasonable necessity to further the policy; SHPDA may approve renewals on a whole, partial, or amended basis when benefits outweigh foreseeable anticompetitive effects. SHPDA must adopt rules for ongoing active supervision, may amend or revoke a certificate at any time if activities are no longer reasonably necessary or if benefits no longer outweigh foreseeable anticompetitive effects, and the act becomes effective immediately.

FULL SUMMARY

The bill creates a new Labor Law Section 191-d prohibiting “non-compete agreements” sought, required, demanded, or accepted from covered health related professionals. It defines “covered health related professional” to include specified licensed medical and allied professionals (e.g., physicians, physician assistants, chiropractors, dentists, perfusionists, veterinarians, physical therapists, pharmacists, nurses, podiatrists, optometrists, psychologists, occupational therapists, speech pathologists/audiologists, and mental health practitioners).

A “non-compete agreement” is defined broadly to include agreements or clauses that (i) prohibit practice with a new employer, (ii) impose financial penalties/repayment or require reimbursement of bonuses/training expenses/similar payments based primarily or solely on the decision to continue practicing with a new employer, (iii) require employer consent or submission to equitable relief as a condition of practicing with a new employer regardless of geography or specialty, or (iv) impose indirect restrictions limiting or deterring such practice. The definition expressly excludes nondisclosure agreements protecting confidential business information or trade secrets.

The bill provides an enforcement mechanism: affected covered professionals may bring a civil action within two years of the later of the signing date, learning of the agreement, termination of the employment/contract relationship, or an employer step to enforce. Courts may void the prohibited non-compete, enjoin conduct, order liquidated damages (capped at not more than $10,000 per covered professional), and award lost compensation, compensatory damages, and reasonable attorneys’ fees and costs. It also requires that liquidated damages be awarded to every affected professional in addition to other remedies, and includes multiple limitations/clarifications: it preserves protections under other federal/state/local law; it does not limit enforcement of Section 202-k of the Labor Law; it allows non-compete covenants in specified business sale contexts (sale of goodwill or sale/disposition of a majority ownership interest) for covered ownership interests (e.g., owners/partners with at least 15%); it sets conditions for any non-compete deemed permissible/enforceable under New York common law (including reasonableness in time/geography/scope, no undue hardship, no harm to public, and restrictions no greater than necessary, plus a cap that reasonable-in-time terms must be no more than one year and requiring payment of salary during enforcement); and it voids choice-of-law/choice-of-venue provisions intended to evade the section when the professional is (and was for at least 30 days pre-cessation) a New York resident or employed in New York.

The bill also establishes employee notice requirements. Employers must inform employees of protections and rights by posting a notice pursuant to Labor Law Section 45 (as added) in conspicuous, accessible, well-lighted locations. The Department of Labor is tasked with developing the notice, providing it to employers for distribution, and posting it on the department’s website. The act takes effect 30 days after it becomes law, applies to contracts entered into or modified on/after the effective date, and provides that Section 2 (the new notice section) takes effect 180 days after enactment; rules/regulations needed for implementation may be made and completed by the effective date.

FULL SUMMARY

The bill makes several changes to Massachusetts’ electronic health information accessibility framework in chapter 118I and related consumer-protection provisions.

First, it amends chapter 6D (Section 16) by expanding the duties of the consumer protection function to include helping consumers with questions or concerns about electronic health information accessibility requirements under chapter 118I, and requiring the recording and submission of reported violations to the Executive Office of Health and Human Services, the Attorney General, and the Office of the National Coordinator (as defined in chapter 118I).

Second, it amends chapter 118I (Section 7) by adding a compliance mandate: providers in Massachusetts must comply with the 21st Century Cures Act of 2016 (P.L. 114-255), including interoperability, patient access through application programming interfaces (APIs), and prohibitions on information blocking by relevant health IT entities and providers. The executive office, in consultation with the commission, must develop a standardized written notification form for patients explaining their rights and obligations regarding electronic health information accessibility, and the forms may be provided electronically. The executive office must also promulgate regulations prohibiting third-party APIs from collecting/capturing/purchasing/transfering electronic health information without the patient’s express written consent, where consent may be obtained electronically in a conspicuous, easy-to-read format. These regulations further prohibit third-party APIs from disclosing/redisclosing/disseminating/selling/leasing/trading/profiting from a patient’s electronic health information unless doing so is directly to provide data access to the patient with the patient’s express written consent. Violations are punishable by fines under chapter 118I’s Section 8 and constitute unfair or deceptive acts under chapter 93A.

Third, it amends chapter 118I (Section 8) by requiring that violations involving patient access to electronic health information—reported by the commission’s Office of Patient Protection—receive penalties of no less than $1,000 per day per violation. The bill takes effect immediately upon passage.

FULL SUMMARY

The bill establishes a new regulatory framework in Maine for reviewing “material change transactions” involving certain health care entities and private equity companies, hedge funds, or management services organizations. It creates definitions, a pre-transaction notice process to the Department (not less than 180 days before the transaction), a public posting requirement within 10 days of receipt of notice, and a staged review system that can result in (i) approval without comprehensive review, (ii) approval subject to conditions, or (iii) mandatory comprehensive review.

The bill requires a comprehensive review when specified triggers apply, including transactions involving assets valued over $100,000,000, transactions likely to lessen competition, or transactions determined at the Department’s sole discretion to likely have a material impact on cost, quality, equity, or access in any region of the State. For comprehensive reviews, the Department must hold one or more public hearings/meetings (with at least one in the county where the health care entity is located) and the Office of Affordable Health Care may conduct a cost and market impact review considering factors such as service quality and patient experience, consumer concerns/complaints, effects on at-risk/underserved/government payer populations, pricing and market share/competition, workforce impacts, real estate sale/lease impacts, prior related transactions, debt-to-equity, service availability/access in primary and dispersed areas, and compliance with prior conditions and ownership/control reporting requirements. The bill also provides that confidential proprietary information may be designated and limits disclosure, while requiring public posting of the Office’s final report (without confidential information).

The bill grants the Department approval authority over covered transactions, including authority to impose conditions with specified compliance time periods and either an expiration date or indefinite duration; prohibits completion of a proposed transaction before the Department informs the health care entity of its determination; and authorizes cost-shifting to transacting parties for reasonable direct review/oversight costs. It creates post-transaction oversight: the Attorney General may subpoena records and seek enforcement remedies (including specific performance, injunctive relief, equitable remedies, and attorney’s fees), and the Department may audit compliance and impose administrative penalties of $10,000 per day for violations or noncompliance with conditions. It also requires the Department to adopt rules establishing minimum/maximum filing fees (initial fees between $2,000 and $10,000, with nonrefundable fees due upon notice) and provides for rules for other reasonable fees needed to administer the chapter. An exemption applies where the transacting entity is an independent provider organization with no ownership/control entities consisting of 6 or fewer individual providers.

Finally, the bill enacts a new ownership-and-control transparency requirement (22 MRSA §8710-A): covered health care entities must report specified ownership/control information to an organization (i.e., the reporting body referenced in the new section) no later than July 1, 2027 and upon completion of any material change transaction, including legal/operating information, business identification numbers, representative contact information, an organizational chart with affiliates/subsidiaries, and for hospitals, detailed affiliated provider/facility information. Certain entities are exempt (including independent provider organizations of 6 or fewer providers and specified providers/organizations shown on the hospital’s organizational chart, with an exception that health care facilities are not covered by the exception). The organization must share/report ownership information publicly: it must post an annual report starting no later than January 1, 2029 (covering the prior one-year period) and may share information with the Office of Affordable Health Care, the Attorney General, and other state agencies/officials to reduce duplication and facilitate oversight/enforcement, while treating certain individual social security-linked identifiers as confidential. The Act takes effect January 1, 2027.

FULL SUMMARY

The bill amends and reenacts Virginia Code § 40.1-28.7:8, establishing restrictions on employers’ use of “covenants not to compete” (noncompete agreements) in employment relationships and creating private enforcement and civil penalty mechanisms.

Key substantive changes include expanding/clarifying who is covered as a “low-wage employee,” including overtime-entitled workers (29 U.S.C. § 207), certain interns/students/apprentices/trainees (paid or unpaid), and individuals paid below the Commonwealth’s median hourly wage based on Bureau of Labor Statistics data; and excluding employees whose earnings are derived largely from sales commissions, incentives, or bonuses. For low-wage employees, employers are prohibited from entering into, enforcing, or threatening to enforce noncompetes. The bill also makes noncompetes unenforceable when an employer discharges a low-wage employee without providing severance or other monetary payment, unless discharged “for cause,” and requires that such benefits/payment be disclosed when executing the covenant.

The bill clarifies that nothing in the noncompete limits prevents nondisclosure agreements aimed at protecting employees’ access to trade secrets (as defined in § 59.1-336) and proprietary/confidential information. It adds/retains an employee enforcement pathway: an employee may bring a civil action against an employer or other person attempting to enforce an unlawful noncompete within two years of the later of (i) signing, (ii) learning of the covenant, (iii) termination of employment, or (iv) an enforcement step. A court may void the noncompete and award appropriate relief, including injunctive relief, liquidated damages, lost compensation, damages, and reasonable attorney fees and costs. Employers are prohibited from discharging or retaliating against low-wage employees for bringing such an action.

Enforcement also includes: (1) civil penalties for violations of the prohibition on noncompetes and the discharge/severance rule (set at $10,000 per violation, payable to the Commissioner for deposit in the general fund); (2) court-awarded recovery of reasonable costs (including expert-witness fees) and attorney fees if a court finds a violation; and (3) an employer posting requirement to post the section or an approved summary. The bill further specifies administrative penalty escalation for failure to post (warning for first violation; up to $250 for second; up to $1,000 for third and subsequent violations) and provides Commissioner procedures for uncontested penalty payments and consent-to-abatement/settlement without admission. It includes a transition clause stating that nothing in the act invalidates, alters, or otherwise affects contracts/covenants/agreements entered into, amended, or renewed prior to July 1, 2026.

FULL SUMMARY

The bill establishes a “Rhode Island Ban on the Corporate Practice of Medicine Act” by making it unlawful for unlicensed individuals/entities to own a medical practice, employ healthcare licensees, or otherwise engage in the practice of medicine, while allowing limited employment of physicians by certain licensed medical practices and specified public/safety-net providers. It permits physician employment by a medical practice only if physicians licensees hold majority voting share ownership in each class, physicians are the majority of directors, and all officers other than secretary/treasurer (if any) are licensed physicians. It also clarifies that permitted entities must not interfere with, control, or direct a licensee’s professional judgment or clinical decisions.

It regulates contracts and arrangements between medical practices and management services organizations by imposing multiple restrictions: (1) “meaningful ownership” requirements for licensee owners (licensed, present in Rhode Island, and substantially engaged in delivering care or managing the practice); (2) prohibitions on dual ownership/interests and certain compensation arrangements with management services organizations that contract with the practice (with an exception where the medical practice owns a majority interest in the management organization or separate legal entity); (3) prohibitions on transferring or relinquishing control of shares/assets or restricting share transfers. It voids noncompetition agreements between licensees and other persons except where the licensee owns/controls an ownership/membership interest in the other party of at least 25%. It also voids nondisclosure and nondisparagement agreements between a licensee and a management services organization, while preserving causes of action based on libel/slander/tortious interference/other torts independent of such agreement violations. It prohibits management services organizations or other non-practice entities from advertising the medical practice’s services under the entity’s name.

The bill further prohibits relinquishment of de facto control over administrative, business, or clinical operations that affect clinical decision-making or quality of care, including prohibited “ultimate decision-making authority” over a list of matters such as licensing-provider scheduling/time with patients, discharge timing, clinical status determinations, diagnoses/diagnostic codes in the medical record, available clinical orders, staffing levels and patient-visit time periods, clinical standards/policies, billing and collection policies, pricing/amounts charged, and certain payer contract activities. It allows collection of quality metrics required by law or under agreements and allows a medical practice to delegate certain operations to a managed services organization only if the medical practice’s shareholder agreement gives delegation authority exclusively to majority licensee-shareholders and does not relinquish de facto control to non-licensees.

To protect employed licensees, the bill voids restrictive-covenant-type agreements and nondisclosure/nondisparagement agreements between employed licensees and unlicensed employers/entities, and prohibits employer/entity interference with clinical judgment via mechanisms such as discipline, threats, retaliation, excessive pressure, or excessive coercion. It specifies that prohibited interference includes controlling patient time, discharge timing, patient clinical status/admission/observation/palliative/referral decisions, diagnoses/diagnostic terminology/codes entered into the record, limiting clinical order ranges via record configuration, and other actions designated by future regulation. Enforcement is split between (a) Attorney General authority to subpoena records, seek court remedies including specific performance/injunctive relief/equitable remedies, recover attorneys’ fees/costs, impose a $10,000 per day statutory penalty, and rescind/deny approval for material change transactions under a conditional approval process; (b) administrative enforcement and department of health market oversight authority to disapprove violating transactions and refer entities to the Attorney General; and (c) a private right of action in superior court by aggrieved persons, with potential damages (actual or statutory up to $100,000 per plaintiff per violation) and equitable relief if violations are intentional. The bill permits adoption of implementing rules.

In addition to the corporate practice ban, the bill creates a “Rhode Island transparency in ownership and control of healthcare entities” chapter requiring each healthcare entity to report to the department of health on or before January 1, 2027, and annually thereafter, upon consummation of a “material change transaction” described in the corporate practice chapter, with information including entity identity and addresses, operation locations, specified business identification numbers, representative contact, ownership/controlling interest/management services/significant equity investors, an organizational chart (including affiliates and subsidiaries), governance membership and compensation, and comprehensive financial reports (including audited financial statements and other financial metrics). It provides exemptions for certain small independent provider organizations (generally two or fewer physicians, without ownership/control entities) unless a material change transaction occurs, and for provider organizations owned/controlled by another healthcare entity that reports on their behalf (with healthcare facilities excluded from the exemption). It requires the department of health to promulgate rules, impose penalties for noncompliance, may assess administrative fees, and must make submitted ownership/control information publicly available (with confidentiality for individual healthcare provider tax IDs that are also Social Security numbers). It requires annual public website posting summarizing reporting entities, ownership/control changes, tax ID changes, and consolidation trends, and allows information sharing with the Attorney General and other state agencies (subject to confidentiality protections for SSN-based tax IDs). For reporting failures/false reports, it establishes civil penalty caps of $50,000 per report for qualifying smaller entities (generally ≤10 physicians and <$10,000,000 annual revenue) and $500,000 per report for all other entities. The bill takes effect upon passage.

FULL SUMMARY

This bill establishes new, statewide limits on the enforceability of post-employment “covenants not to compete” and on when employers may require workers to sign “exclusivity agreements,” with all operative provisions applying to agreements entered into, amended, extended, or renewed on or after October 1, 2026. It defines key terms including “covenant not to compete,” “exclusivity agreement,” “annualized monetary compensation,” “base salary and benefits,” and “legitimate business interest,” and it sets wage-based thresholds for employees and independent contractors.

A covenant not to compete is void and unenforceable if it applies to workers below specified pay levels (employees with hourly wage less than 2× the minimum fair wage; independent contractors with hourly wage less than 5× that amount), or if it is overbroad in geographic scope (covering areas where the worker had no services/material presence/influence in the prior two years) or in the type of work (covering work the worker did not do in the prior two years). For workers meeting the wage thresholds, the bill allows enforcement only if multiple conditions are met: a duration limit of up to one year (up to two years only if the worker is compensated with base salary and benefits for the entire duration); necessity to protect a legitimate business interest that cannot reasonably be protected by less restrictive means (including nondisclosure/nonsolicitation or trade secrets law) and is no more restrictive than necessary in duration, geography, work type, and employer type; the worker must be an “exempt employee” under federal Fair Labor Standards Act exemptions; and detailed procedural/contracting requirements apply (timely delivery with required notice content, separate signature by the parties, sufficient consideration if added to an existing agreement, limits on worker-forced adjudication outside Connecticut, consistency with state law, and proof-allocation rules in enforcement).

The bill also prohibits employers or contractors from requesting or requiring exclusivity agreements unless wage/threshold criteria are met (exempt employees >2× minimum fair wage; independent contractors >5×) or unless certain safety/public-harm or scheduling-interference conditions are satisfied (and expressly excludes on-call shift scheduling from being a “reasonable scheduling expectation”). Courts are barred from modifying noncompete or exclusivity provisions that violate the bill for enforcement purposes; however, severable prohibited provisions may be separated from the remainder of the agreement, which must remain in force if unrelated. In any enforcement proceeding, the party seeking to enforce bears the burden of proof; where the employer agreed to pay base salary and benefits for the noncompete duration, the payor bears the burden in proceedings seeking to stop paying. Workers may bring civil actions in Superior Court for damages, civil penalties, and equitable/injunctive relief, and prevailing workers may recover reasonable costs and attorney’s fees; courts may assess civil penalties up to $5,000.

The Attorney General is authorized to investigate, intervene in, or bring civil actions on behalf of the state when there is a practice or pattern of subjecting workers to prohibited noncompetes or exclusivity agreements. The bill grants subpoena/interrogatory authority (with a limitation that information obtained cannot be used in criminal proceedings), requires distribution of awarded damages to injured workers if the AG prevails, and allows civil penalties up to $5,000 against each defendant. It also permits the AG to accept an assurance of discontinuance and provides that evidence of breach becomes prima facie proof in subsequent AG actions; it clarifies that the AG cannot sue where the claim would otherwise be barred by the statute of limitations. Finally, it repeals and substitutes Connecticut’s existing noncompete restriction statute (General Statutes § 31-50a) for certain security-guard/noncompete rules, limiting applicability to agreements entered into, renewed, or extended before October 1, 2026; the bill’s new sections and the statutory substitution take effect October 1, 2026.

FULL SUMMARY

HB5301 establishes the Global Hospital Budget Authority Act, creating a Global Hospital Budget Authority as a division of the Illinois Department of Public Health and placing its powers and duties in a Global Hospital Budget Board. The Board is empowered to select hospitals for participation, provide technical assistance, collect and analyze data, calculate and administer global budgets, review and approve hospital transformation plans, monitor global budgets and quality metrics, require corrective action plans, and terminate participant hospitals for specified failures. The act also creates a Global Hospital Budget Fund in the State Treasury, provides for annual independent audits (publicly available), requires annual electronic reporting on performance and compliance (including rural hospitals), and requires that Board discussions and actions be limited to administration of the global budget model as set out in the act and Board bylaws.

The Board is structured with state officials plus members selected by participating payers (insurers and Medicaid managed care organizations, with exclusions for affiliated Medicaid MCOs), participant hospital members (capped at the number of participating payer members and selected with geographic diversity requirements), and additional Governor-appointed public/consumer and expert members. Board governance provisions include quorums, open-meetings compliance, conflict-of-interest recusal and nondisclosure of confidential information where conflicts exist, expense reimbursement funded by the Fund, and timelines for forming the Board. Participating payers may enter the model by letter of interest and must sign participation agreements detailing terms; participating hospitals must sign agreements and submit transformation plans (including an initial rural hospital budget transformation plan and annual updates). Data collection is authorized from participating payers and hospitals as needed for the global budget model; data use is restricted to administering the model without written approvals for other uses, raw patient-identifying data are prohibited from access, and authority retention is capped at 7 years.

Confidentiality and evidentiary protections apply to contracts/agreements and data maintained for the act’s purposes, prohibiting discoverability or admissibility as evidence in civil, criminal, or administrative proceedings, while still permitting access necessary to carry out responsibilities and to provide data to CMS or other entities consistent with applicable laws, including HIPAA and related authorities. The act delineates roles of payers and participant hospitals, including that payers can terminate participation with participant hospitals under agreement terms, and that rural participant hospitals may authorize their insurer/administrator to provide payment data for eligible hospital services under their employee health plans.

The bill also amends Illinois’s Hospital Licensing Act and the Illinois Health Facilities Planning Act. In the Hospital Licensing Act, the Department must accept specified alternative mechanisms (on-site staffing by appropriately licensed clinicians; written and operative affiliation agreements meeting Department standards; documented telemedicine coverage meeting standards; or a rural/critical access waiver under defined provisions) as satisfying staffing and service-line presence requirements when patient safety and continuity of care are maintained, with time-limited waiver approvals and renewal conditioned on continued need and compliance with quality/transfer metrics. It further adjusts physician employment and clinical service/specialty presence requirements by allowing physicians to be employed in all branches if employment, privileging, and oversight requirements are met, and for specialty presence to be satisfied in whole or in part through telemedicine arrangements, affiliation agreements, shared staffing models, or approved waivers, provided written transfer agreements and continuous quality assurance measures exist.

In the Health Facilities Planning Act, the bill adds or revises provisions for (i) exemptions for change of ownership of a health care facility, (ii) applications for permit for discontinuation of a health care facility or category of service, and (iii) public notice and public hearing procedures. For change of ownership exemptions, it expands procedural requirements including newspaper notice and posting/sending to officials, requires additional certification concerning charity care restrictiveness for 2 years after a transaction, conditions exemption issuance on a post-closing compliance statement within 90 days (or longer as provided), defines circumstances for expedited action when changes are among related persons, and introduces extensive disclosure and documentation requirements for “covered transactions,” including ownership chain and beneficial owner disclosure (including private equity/pooled-investment entities), audited/pro forma financial statements and sources/uses of funds, a CHIA prepared by an independent qualified third party, and a post-transaction monitoring/community benefit/employee transition protections plan. It provides Board decision authority to approve, deny, or approve with conditions, including minimum service-level guarantees, staffing levels, investment commitments, restrictions on dividends/leveraged recapitalizations, charity care maintenance, and enforceable monitoring/penalties for noncompliance.

Separately, for closure or discontinuation of facilities/services, the bill requires CHIA consistent with Board rules before approving applications, prohibits approval when likely to degrade essential health outcomes, worsen geographic access to emergent/urgent care, or impose an undue increase in travel time, mandates that facility closure applications be complete only with evidence of at least 30 days’ prior written notice to specified governmental entities, establishes notice of closure to legislators and additional monitoring for at least 5 years post-closure/service reduction (with reported access indicators, staffing, charity care, and community health indicators), and addresses Board deferral authority in specified circumstances (e.g., pending lawsuits and pandemic-related timelines). It also revises State Board powers relating to health facilities planning review procedures, including expeditious review rules and written decision issuance on request.

FULL SUMMARY

The bill establishes new limits on post-employment restrictive covenants for healthcare workers in Utah and creates additional restrictions on nonsolicitation agreements related to healthcare workers. It also expands existing protections tied to unenforceability of healthcare worker non-compete agreements by defining additional terms in Chapter 34-51 and creating a new statutory section addressing healthcare nonsolicitation agreements.

It amends Utah’s non-compete framework by (1) defining “healthcare non-compete agreement” and expanding “healthcare worker” to cover a broad set of licensed healthcare professionals; (2) amending the definition of “non-compete agreement” to clarify that it covers agreements where the employee will not compete in providing a similar “product, process, or service,” and excluding nonsolicitation, nondisclosure, and confidentiality agreements from the non-compete definition; and (3) prohibiting on or after May 6, 2026 any “healthcare non-compete agreement” between a person and a healthcare worker, with any violating non-compete treated as void.

The bill further amends the exceptions and enforcement provisions: it adjusts “exceptions” to permit non-compete and healthcare non-compete agreements related to the sale of a business when value is received in connection with the sale; it amends the award-of-costs/fees/damages rule so that if an employer seeks to enforce an (including healthcare) non-compete and it is determined unenforceable, the employer is liable for arbitration costs (if arbitration is sought), attorney fees and court costs, and actual damages. It repeals an existing “title” section related to the chapter and enacts a new “nonsolicitation agreements” provision barring, on or after May 6, 2026, healthcare nonsolicitation agreements that prevent a healthcare worker from informing a patient of the worker’s current or future place of employment, with violating agreements void.

Finally, it makes a technical/conforming amendment to the statute governing limits on nondisclosure and non-disparagement clauses by aligning references to “non-compete agreement” and reaffirming that the confidentiality-clause protections do not prohibit requiring an employee to sign a non-compete agreement or to agree not to disclose certain non-public trade secrets/proprietary information or confidential information that does not involve illegal acts. The effective date is May 6, 2026.

FULL SUMMARY

The bill changes Utah’s “health care services platform” registration framework by revising definitions and clarifying which health professionals are excluded from the platform requirements. It amends Utah Code § 58-90-101 (enacted in 2025, Chapter 457) to add an “advanced practice provider” definition and to revise the definition of “health care worker” to exclude a physician and an advanced practice provider.

Under the amended definitions, “advanced practice provider” includes individuals licensed as (1) an advanced practice registered nurse, (2) a certified nurse midwife, or (3) a physician assistant. The “health care worker” definition is modified so it no longer includes physicians or advanced practice providers; accordingly, the platform registration and operational compliance provisions apply to other health care workers rather than to those excluded professionals.

All other substantive provisions in § 58-90-101 remain in place as previously enacted: a division registration program is established for health care services platforms, a registration requirement applies beginning January 1, 2026, platforms must register (and pay fees), retain required records for each shift (including licensing/training/continuing education criteria, background check completion, and liability insurance), and comply with platform prohibitions on non-compete requirements, certain fee/benefit arrangements, and restrictions on workers using other platforms or seeking other employment.

The bill’s effective date is May 6, 2026.

The bill adds a new provision to South Dakota’s chapter on noncompete-related law (chapter 53-9). It authorizes parties, in any governing document of a business entity or in a contract tied to the purchase, sale, or transfer of an ownership interest, to agree that an owner—after transferring their ownership interest—may not directly or indirectly engage in the same or similar type of business conducted by the entity. The restriction must apply within the specified geographic area where the entity conducts business and may last no more than three years from the date of the transfer.

No other substantive provisions are included; the enrolled act consists solely of this newly added authorization/limitation for post-transfer noncompete agreements tied to jointly owned business entities.

FULL SUMMARY

The bill establishes a revised framework for non-compete agreements in Utah, including new definitions, detailed limits on when non-competes may be entered into or enforced against employees and independent contractors, and new notice/offer-of-employment requirements.

For employees, employers generally may not enter into non-compete agreements longer than one year after employment ends (continuing the post-employment duration limit for non-compete agreements entered on or after May 10, 2016). Beginning May 6, 2026, the bill bars enforcement against certain employees, including nonexempt employees, individuals age 18 or younger, and students working during internship/short-term employment, and also bars enforcement where the employee’s total earnings in the most recent calendar year are under $155,000, or where the employer terminates the employee due to a reduction in force; non-compete agreements entered on or after May 6, 2026 are likewise unenforceable against independent contractors.

The bill requires employers, when making an offer of employment, to include any non-compete agreement they intend to enter into with the offer and to present it in a manner a reasonable person would understand, with a statutory reference to the new section included in the offer/contract. It also requires advance written notice at least 14 calendar days before the earlier of the employee starting work or the non-compete becoming effective. Non-compete agreements that violate the bill’s employee/contractor limitations are made void, and employers that fail to comply with the offer inclusion and notice requirements may not enforce the agreement. Broadcasting-industry non-competes are retained but tightened: they are only valid if the broadcasting employee is an exempt broadcasting employee and if specified contractual and termination/breach conditions are met; additionally, enforceability is capped at the earlier of one year after the employee is no longer employed or the end of the original contract term, and non-compliant broadcasting non-competes are void.

The bill creates enforcement and remedies. It makes a non-compete violation actionable: an employee or independent contractor may bring a right of action against a person seeking to enforce a non-compete that violates the chapter if the individual is a party to the agreement. In arbitration, if an arbitrator determines the non-compete violates the chapter, the arbitrator must award the employee costs of arbitration, attorney fees and court costs, and actual damages; in court, if a court finds the non-compete violates the chapter, it must award actual damages, injunctive relief, arbitration costs, and reasonable costs and attorney fees. The bill also adjusts exceptions by clarifying that the chapter does not prohibit or affect reasonable, mutually agreed severance agreements that include non-compete provisions, and it preserves a sale-of-business exception when the individual receives value related to the sale. Finally, it repeals the former Section 34-51-101 (Title) and takes effect on May 6, 2026.

FULL SUMMARY

The bill establishes the Global Hospital Budget Authority Act, creating the Global Hospital Budget Authority as a division within the Illinois Department of Public Health. The Authority’s powers are vested in a Global Hospital Budget Board that has sole authority to hire board staff and that employs non-state employees (executive director, legal counsel, consultants, and other staff as needed). The Board has broad responsibilities to select eligible hospitals, provide technical assistance, collect and analyze data, calculate and administer “global budgets,” review and update the definition of “eligible hospital services” (subject to federal approvals), monitor global budgets and quality metrics, require corrective action plans, terminate participant hospitals for noncompliance, contract for independent evaluation, and conduct annual assessment of rural participant hospitals’ compliance with transformation plans and budget targets; it also requires annual audits by an independent certified public accounting firm that are public and mandates annual electronic reporting on performance/compliance (including financial and audit publication in the Illinois Register).

The bill defines a global budget payment model in which participating payers pay participant hospitals using a prospectively set annual “global budget” for “eligible hospital services,” and it sets participation roles and conditions. Payers may submit letters of interest and, as a condition of participation, must sign an agreement with the Authority detailing participation terms; they can terminate participation with a participant hospital under agreement terms. Hospitals may submit letters of interest and, as a condition of participation, must submit initial rural hospital budget transformation plans and annual updates, and sign participation agreements. Data collection is authorized from participating payers, rural participant hospitals, rural hospitals, and the Department of Human Services; the Authority may use collected data only to administer the global budget model, must retain data no longer than 7 years, and faces restrictions on releasing or granting access to raw data that could identify patients or certain other sensitive data; a rural participant hospital may authorize its insurer/administrator to provide payment data regarding eligible services under the hospital’s employee health plan.

The bill creates confidentiality rules covering contracts, agreements, and data maintained by the Authority for purposes of the Act, stating such material generally is confidential and not discoverable or admissible as evidence in civil, criminal, or administrative proceedings, while preserving the Authority’s ability to access data to carry out its responsibilities and requiring CMS/other disclosures consistent with applicable federal and state laws and written agreements. It also creates the Global Hospital Budget Fund as a separate State Treasury fund, restricts use of deposited moneys to effectuating the Act’s purposes, provides that interest and returned moneys must be deposited back into the Fund, and amends the State Finance Act to add the Fund. Finally, it establishes the Global Hospital Budget Board’s operating governance (membership categories and term structure, quorum, chair selection, recusal/conflict safeguards, Open Meetings Act applicability, and board formation within 90 days) and gives the Board authority to seek state and federal waivers and to establish advisory groups.

Separately, the bill makes targeted changes to existing hospital regulation and facility planning laws. In the Hospital Licensing Act, it modifies the Department’s permit and licensing review approach to accept alternative mechanisms that can satisfy staffing and service-line presence requirements if patient safety and continuity of care are maintained—on-site staffing by appropriately licensed clinicians; written and operative affiliation agreements meeting Department standards for timely specialty coverage; documented telemedicine coverage meeting Department standards; or a waiver for rural/critical access hospitals, with waiver approvals time-limited (not exceeding 24 months, renewable with continued need and quality/transfer metric compliance) and Department technical assistance/template duties for applicants. It also updates the physician employment requirements to allow employing entities to employ physicians in all branches if employment/privileging/oversight requirements are met, and it specifies that clinical service/specialty presence may be satisfied in whole or in part through documented telemedicine arrangements, affiliation agreements, shared staffing models, or approved waivers, provided written transfer agreements, response-time expectations, credentialing consistent with the standard of care, and measures to assure continuous quality of care are maintained.

The bill amends the Illinois Health Facilities Planning Act by changing provisions relating to (1) definitions (including detailed definitions for facility transactions and other planning terms), (2) certification of exemption procedures and public notice/hearing requirements for certain change-of-ownership and service-discontinuation applications, (3) the permit application process and review criteria (including Community Health Impact Assessment (CHIA) requirements tied to closure/discontinuation decisions), (4) covered transactions involving material change in ownership/control where conditions may be imposed, including CHIA analysis, independent evaluation, public comments/interventions, Board denial authority, and post-transaction compliance monitoring with possible penalties/restoration/divestiture, and (5) State Board powers and duties, including expedited review timing rules and long-term care rulemaking processes. It also adds State Board staff report formatting requirements for various application types and includes additional requirements/conditions for specific facility types and transactions.

FULL SUMMARY

The bill establishes Rhode Island’s “Ban on the Corporate Practice of Medicine” by creating new Title 23 Chapter 106. It generally makes it unlawful for an unlicensed individual or entity (including corporations, partnerships, and other organizations) to own a medical practice, employ healthcare licensees, or otherwise engage in the practice of medicine, while carving out a protection that permitted non-licensed entities may not interfere with or direct a licensee’s professional judgment or clinical decisions.

Chapter 106 also permits certain corporate/organizational structures to employ physicians and engage in the practice of medicine. Medical practices may employ physicians only if physicians licensed in Rhode Island hold the majority of each class of voting shares, the majority of directors, and (with limited exceptions for secretary/treasurer) officers are Rhode Island-licensed physicians. The bill expressly allows specified types of entities to employ physicians (safety net clinics and certain public providers such as federally qualified health centers and rural health clinics; public hospitals; health and hospital districts; school-based health clinics; and tribal health clinics). It additionally requires that licensee owners have “meaningful ownership,” prohibits dual ownership/control between a medical practice and a management services organization with which it contracts (with an exception where the medical practice owns a majority interest in the management entity/separate legal entity), prohibits stock transfer/control restriction agreements, and prohibits a set of arrangements that effectively shift administrative/business/clinical control away from the medical practice.

Chapter 106 further restricts contracts and management relationships through enforceable bans: noncompetition agreements are void/unenforceable unless the licensee has at least a 25% ownership or control interest in the other party; nondisclosure and nondisparagement agreements between a licensee and a management services organization are void/unenforceable (while preserving causes of action for torts such as libel/slander and certain interference claims independent of breach of the prohibited contract). It bans management services organizations or other non-practice entities from advertising the medical practice’s services under the name of the non-practice entity. It prohibits medical practices from relinquishing de facto control over administrative, business, or clinical operations affecting clinical decision-making or care quality, listing examples of impermissible interference with clinical operations and decisions (e.g., controlling time spent with patients, time to discharge, clinical status, diagnoses/codes entered into records, limits on clinical order options, and other actions specified by regulation), while allowing quality-metrics collection required by law and permitting delegation of operations to managed services organizations only where delegation is bestowed exclusively on majority licensee-shareholders and does not relinquish de facto control to non-licensees. The bill includes “protections for employed licensees” that extend these restrictive-covenant and interference protections to situations where licensees are employed by, or contract with, unlicensed entities.

Enforcement is established through attorney general authority (subpoenas, full legal enforcement including damages; specific performance, injunctive relief, equitable remedies; attorney’s fees and costs; and statutory penalties of $10,000 per day per violation/imminent violation/conditional-approval condition breach, plus the ability to rescind or deny approval for certain material transactions). The department of health engaged in market oversight can disapprove violating transactions and refer matters to the attorney general; administrative penalties also run at $10,000 per day. A private right of action is created for aggrieved persons in superior court, with potential damages (including statutory damages up to $100,000 per plaintiff per violation) and equitable relief where intentional violations are found. The bill also authorizes the department of health to adopt implementing rules.

Separately, the bill creates Title 23 Chapter 107 (“Rhode Island Transparency in Ownership and Control of Healthcare Entities”), requiring healthcare entities to report to the department of health on or before January 1, 2027, and annually on or before January 1 thereafter, upon consummation of “material change” transactions described by Chapter 106. Report contents include legal/business details; multiple identification numbers (including tax, provider, CMS, NAIC, insurance-related personal ID, and pharmacy benefit manager ID where applicable); representative contact information; names and details for persons/entities with ownership, control, management services roles, or significant equity investment; organizational charts; affiliated provider/facility details for provider/facility types; governance body membership and compensation; and comprehensive financial reports. The bill exempts certain small independent provider organizations (with a re-trigger if a material change transaction occurs) and certain provider organizations controlled by another healthcare entity that files on their behalf (but not healthcare facilities). It requires public posting of certain ownership/control information and annual department reports on a public website, with confidentiality treatment for an individual provider’s taxpayer ID if it is also a Social Security number. Compliance is enforced through audit/inspection authority, random annual audits, and civil penalties capped at $50,000 per report for smaller entities (as defined by physician count or revenue threshold) and up to $500,000 per report for other entities. The act takes effect upon passage.

The bill establishes a requirement for the University of Iowa Hospitals and Clinics (UIHC) to prohibit noncompete clauses in physicians’ employment contracts.

It amends Iowa Code section 262.9 (Code 2026) by adding a new subsection that directs the Board of Regents to “develop a policy” that prohibits UIHC from including a noncompete clause in an employment contract with a physician.

The bill defines a “noncompete clause” as any restriction on a physician’s right to practice either (1) within any geographic area or (2) for a defined period of time, upon termination of the physician’s employment contract with UIHC. It defines “physician” as an individual licensed under Iowa Code chapter 148. The prohibition applies to all UIHC employment contracts with physicians 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 new limits on the “corporate practice of medicine” by prohibiting non-licensee entities (and certain nonclinical roles within corporate structures) from owning, controlling, or directing the professional judgment and ultimate clinical decisions of licensed clinicians. It applies to professional service medical corporations and, through parallel new provisions, to hospitals, private establishments, ambulatory surgical facilities, nursing homes, birthing centers, in-home care agencies, telemedicine-exclusive medical practices, health care service contractors organized as prepaid integrated care delivery systems, and health maintenance organizations. Across these settings, the bill prohibits interference or control over clinical decision-making by prescribing that the only permitted persons directing ultimate clinical decisions are physicians/osteopathic physicians/advanced registered nurse practitioners (and their designated designees who are licensed health care providers) acting within scope of practice; it also lists examples of prohibited conduct, including setting or limiting clinical decision variables (time with patients, discharge timing, inpatient/observation status, diagnoses and codes entered, and the range of clinical orders via medical record configuration).

For medical professional service corporations, the bill also adds governance and ownership requirements for professional service corporations: medical licensees must hold all voting shares, hold all director positions, and hold all officer positions except secretary and treasurer; medical licensees must exhibit “meaningful ownership” by substantially engaging in care delivery or practice management. The bill further restricts medical licensees from dual participation or compensation arrangements with management services organizations (with an exception for management services organizations wholly owned by a medical licensee/medical licensees), and restricts transferring or relinquishing control over the practice’s administrative, business, or clinical operations that affect clinical decision-making or quality (with an exception for transfers only to another medical licensee). It also adds a telemedicine-exclusive and integrated prepaid contractor-specific variant, including a specific limitation on controlling clinical decisions in telemedicine-exclusive practices (including ability to recommend/referral to in-person treatment).

The bill adds compliance carve-outs stating that nothing prohibits policies or requirements necessary to comply with state/federal laws, coding guidelines, or third-party payor requirements (so long as they do not circumvent state/federal laws), and it allows requirements for credentialing/privileging, quality improvement, peer review, regulatory actions, Medicare/Medicaid conditions, or the physician health program under chapter 18.71 RCW. It also adds consumer protection enforcement hooks for the telemedicine-exclusive provision: violations are deemed unfair or deceptive acts for purposes of Washington’s Consumer Protection Act, with enforcement exclusive to the Attorney General. Additionally, it amends existing unprofessional conduct rules to add as unprofessional conduct a violation of the new corporate practice provisions (including specifically adding “violation of section 11 of this act” to the unprofessional conduct list) and expands the disciplinary enforcement framework by directing the secretary to investigate and pursue cease-and-desist orders for unlicensed practice that includes violations of section 1.

Finally, the bill requires certain health license applicants (physicians, osteopathic physicians, physician assistants, naturopaths, and advanced registered nurse practitioners) to attest during license or renewal applications that they are aware of the corporate practice of medicine regulations contained in sections 1 through 11. It amends the corporate practice-related franchise stop-order statute to treat violations involving section 1 of this bill as illegal where performed. The act takes effect January 1, 2028.

FULL SUMMARY

The bill establishes comprehensive state rules limiting noncompetition covenants in employment and contracting in Washington. It also clarifies that nonsolicitation agreements are not prohibited, but must be narrowly construed, and that provisions in the chapter facilitating workforce mobility must be liberally construed while exceptions are narrowly construed.

It changes RCW 49.62.005 and RCW 49.62.010 by revising legislative findings and definitions. Definitions are modified to clarify what counts as a “noncompetition covenant” (including broad restraints on lawful professions/trades/businesses; certain performer restraints; indirect prohibitions on accepting or transacting with customers; and penalty/forfeiture provisions tied to engaging in lawful work). The definition of “nonsolicitation agreement” remains as a post-termination restriction on soliciting employees or customers, and the bill expressly clarifies that agreements that directly or indirectly prohibit accepting or transacting business with a customer are not “nonsolicitation agreements.”

It substantially changes enforcement and remedies under RCW 49.62.020 and RCW 49.62.080 by making noncompetition covenants void and unenforceable regardless of when the parties entered into them, and by prohibiting employers from enforcing, attempting to enforce, threatening to enforce, representing that a worker is subject to such a covenant, or entering/attempting to enter noncompetition covenants. The bill also requires, by October 1, 2027, written notice to current employees, former employees, and independent contractors who were required to enter noncompetition covenants (or whose contracts include them) stating the covenants are void and unenforceable. For violations, it provides that a violator must pay the greater of actual damages or a $5,000 statutory penalty plus reasonable attorneys’ fees, expenses, and costs, and authorizes cause(s) of action for violations of the chapter.

It amends RCW 49.62.090 to maintain the chapter’s displacement of conflicting laws while preserving chapter 19.108 RCW (and related common-law development language). It amends RCW 49.62.100 to apply specified provisions to proceedings commenced on or after the bill’s effective date, regardless of when the underlying cause of action arose. Finally, it repeals RCW 49.62.030, RCW 49.62.040, and RCW 49.44.190, and sets the act’s effective date as June 30, 2027.

FULL SUMMARY

The bill establishes a new labor-law framework that prohibits employers from seeking, requiring, demanding, or accepting non-compete agreements from specified “covered health related professionals.” It defines a broad set of covered professions (including, among others, physicians, physician assistants, chiropractors, dentists, perfusionists, veterinarians, physical therapists, pharmacists, nurses, podiatrists, optometrists, psychologists, occupational therapists, speech pathologists/audiologists, and mental health practitioners) and defines “non-compete agreement” to include certain restrictive provisions tied to a professional’s decision to work for a new employer. It also clarifies that nondisclosure agreements protecting confidential business information or trade secrets are not treated as non-compete agreements under this section.

Substantively, the bill prohibits covered health related professionals from being restricted via non-compete terms in four ways: (1) preventing the professional from practicing medicine with a new employer; (2) imposing specified financial penalties, repayment obligations, or reimbursement of bonuses/training expenses (etc.) when those obligations are based solely or primarily on the professional choosing to continue practicing with a new employer; (3) requiring, as a condition of working for a new employer, that the professional obtain employer consent or submit to equitable relief; and (4) imposing indirect restrictions that effectively limit or deter the professional from practicing with a new employer. It provides that any non-compete agreement sought/required/demanded/accepted after the effective date is null, void, and unenforceable.

The bill creates a private civil enforcement mechanism. Covered health related professionals may sue employers (and other alleged violators) for violations, with a two-year limitations period tied to the later of several triggering events (signing; learning of the agreement; termination of employment/contract relationship; or when the employer takes steps to enforce). Courts may void the prohibited non-compete and grant broad relief, including injunctions, liquidated damages, lost compensation, compensatory damages, and reasonable attorneys’ fees and costs. Liquidated damages are capped at $10,000 per covered professional, and the court must award liquidated damages to affected professionals in addition to other remedies.

The bill includes additional operational rules and related notice requirements: it states the new protections do not limit other state/federal/local laws regarding agreements establishing fixed terms and/or exclusivity during employment, or confidentiality/trade secret/client information protections; it permits non-compete covenants in the sale of business goodwill or disposition of a majority/qualifying ownership interest in specified ownership-percentage scenarios (with a 15% threshold appearing in both categories); it imposes enforceability requirements for any non-compete agreements that remain permissible (time/geography/scope reasonableness under New York common law principles, no undue hardship or public harm, legitimate business interest protection, and a maximum one-year restriction term when time-reasonableness is met, plus payment of salary during enforcement); it bars choice-of-law or choice-of-venue provisions that would avoid or limit these requirements for covered individuals who were New York residents or worked in New York for at least 30 days immediately before cessation (including certain remote workers reporting to a NY worksite/office or NY-based supervisor); and it requires employers to post notice of these rights. The bill tasks the Department with developing a standardized notice to be provided to employers for distribution and posted on the department’s website. The effective date is the thirtieth day after enactment for the main provisions, while the notice-related section takes effect on the one hundred eightieth day after enactment.

The bill amends Tennessee Code Annotated, Title 68, Chapter 11, Part 13 (Hospital Cooperation Act of 1993) by adding a new prohibition section, 68-11-1311, addressing anti-competitive agreements and conduct among hospitals.

New section 68-11-1311 establishes (via legislative findings) that the “COPA”/hospital cooperation antitrust exemption scheme has produced public harms and has “failed,” and it states the state’s policy is no longer to displace competition among hospitals.

Operatively, 68-11-1311 provides two enforceable prohibitions, notwithstanding other law: (1) a hospital may not negotiate, enter into, or otherwise engage in anti-competitive agreements or anti-competitive conduct with other hospitals in Tennessee; and (2) state funds may not be used to facilitate or otherwise further “active supervision” of anti-competitive conduct in the healthcare sector.

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

FULL SUMMARY

The bill establishes a new prohibition on employers seeking, requiring, demanding, or accepting non-compete agreements from covered individuals and from specified health-related professionals. It also authorizes covered individuals (including health-related professionals) to sue to void non-competes and obtain relief, and directs employers and the Department of Labor to provide employee-facing notices about these rights.

It creates Labor Law § 191-d defining “non-compete agreement” as any clause that restricts a covered individual from obtaining employment after the end of employment, and defining “covered individual” as a person (other than a “highly compensated individual”) who performs work/services for another on terms creating economic dependence and a duty to perform services. “Highly compensated individual” is defined by an income threshold of at least $500,000 per year (based on the three most recent W-2s and, where applicable, K-1s; for shorter employment, using all such statements), adjusted each calendar year starting in 2027 using New York CPI for all Urban Consumers. The bill defines “health related professional” as specified licensed medical and other health practitioners under enumerated Education Law articles. For these categories, any non-compete sought/required/demanded/accepted after the law’s effective date is null, void, and unenforceable.

The bill provides an enforcement mechanism: a covered individual or health-related professional may bring a civil action within two years of the later of (i) signing, (ii) learning of the prohibited non-compete, (iii) termination of the employment/contract relationship, or (iv) the employer taking a step to enforce. Courts may void the agreement and order appropriate relief, including injunctions, liquidated damages (capped at up to $10,000 per affected person/professional), and awards of lost compensation, compensatory damages, and reasonable attorneys’ fees and costs. It clarifies that nothing limits other federal/state/local protections that allow certain agreements during employment—such as fixed-term/exclusivity arrangements, trade secret restrictions, confidential/proprietary client information restrictions, and client non-solicitation—provided they do not otherwise restrict competition in violation of the new section.

It allows non-compete/non-similar covenants in specified sale-of-business contexts (sale of goodwill; or sale/disposition of a majority ownership interest) when the ownership thresholds are met (e.g., at least 15% ownership by certain partners/members/entities, or the seller owning at least 15% of the business). It also sets conditions for any permissible/enforceable non-compete under the section (reasonableness under New York common law, with an added rule that any time restriction is not greater than one year, and requiring payment of salary during enforcement) and makes unenforceable any choice-of-law/choice-of-venue provisions designed to avoid the new requirements for individuals who were New York residents or employed in New York for at least the 30 days immediately before employment cessation. The bill adds a new Labor Law § 45 requiring the Department of Labor to develop and distribute/post a notice informing employees of their protections under § 191-d. The act takes effect on the 30th day after becoming law, applies to contracts entered into or modified on or after that date (no retroactive effect), with § 2 (the notice provision) taking 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 establishes a statewide prohibition on non-compete clauses and no-poach agreements, and creates related employee notice, enforcement, and penalty requirements. It defines key terms broadly, including “worker” (covering paid or unpaid individuals, including employees, independent contractors, interns, volunteers, apprentices, sole proprietors, and franchisees in certain contexts) and “non-compete clause” (including written or oral contractual terms or workplace policies that restrain, penalize, or hinder a worker from seeking or accepting other work, or from operating a business, after the employment relationship ends). It also defines “no-poach agreement” as restrictions among employers that hinder hiring of workers or hinder workers from obtaining employment.

For workers who are not “senior executives” (defined as policy-making-position employees with annualized total compensation of at least $151,164), the bill bars employers from seeking, requiring, demanding, or accepting non-compete clauses after the act’s effective date, from enforcing or attempting to enforce any non-compete clause (including those entered before enactment), and from representing that a worker is subject to a non-compete clause. For “senior executives,” similar post-enactment restrictions apply, but existing senior-executive non-competes remain enforceable only if they meet specified conditions and are provided with required disclosures and other compliance protections.

Existing non-compete clauses in effect at enactment are addressed in two ways: (1) for non-senior-executive workers, employers must provide a clear and conspicuous notice within 30 business days stating the clause will not and cannot legally be enforced, using prescribed “model language” (with permitted translation). (2) for senior executives, any pre-existing non-compete clause is void and not enforceable unless the employer provides a written disclosure within 30 business days (including what revisions are needed for compliance and that the worker may consult counsel), and the clause is no broader than necessary to protect legitimate employer interests (including trade secrets/confidential information), lasts no more than 12 months after termination, is geographically and functionally limited to the relevant areas/services during the prior two years, does not penalize workers for challenging enforceability, cannot use choice-of-law to evade the act if the worker is a New Jersey resident or employed in the state for at least 30 days prior to termination, does not restrict work for customers when the worker does not initiate/solicit, is not unduly burdensome or contrary to public policy, and includes additional protections such as voiding if the employer fails to provide written intent to enforce within 10 days after termination (unless the worker was terminated for misconduct). The bill also requires that, during the post-employment period the worker is prevented from working due to the non-compete, the employer must pay 100% of the worker’s pay that they would have earned and make needed fringe-benefit contributions, subject to misconduct/breach exceptions.

The bill declares no-poach agreements void as contrary to public policy and authorizes civil enforcement. A worker affected by a prohibited non-compete or no-poach agreement may sue for relief, including voiding the clause/agreement, injunctive relief, liquidated damages capped at $10,000, lost compensation/damages, and reasonable attorneys’ fees and costs; the action may be filed within two years of the later of signing/learning, termination, or the employer taking steps to enforce. Employers must post the act (or an approved summary) and provide required notices; failures trigger a warning for the first violation and escalating fines for subsequent violations (up to $250 for the second and $1,000 for the third and later), collected under the state’s Penalty Enforcement Law of 1999. The act takes effect immediately.

FULL SUMMARY

The bill amends Massachusetts employment-protection law (M.G.L. c. 149) by adding definitions for “political matters” and “religious matters,” and by modifying/expanding the circumstances under which employers may not discipline or discharge employees based on First Amendment-related political and religious speech or employee refusals to participate in certain employer messaging.

Under the amended Section 20F, an employer (including the state and its instrumentalities or political subdivisions) is liable for damages—including punitive damages, reasonable attorney’s fees, and the full amount of gross loss of wages/compensation—if it subjects or threatens to subject an employee to discipline or discharge on account of: (1) the employee’s exercise of First Amendment rights, so long as the activity does not substantially or materially interfere with bona fide job performance or the employer-employee working relationship; or (2) the employee’s refusal to (a) attend an employer-sponsored meeting whose primary purpose is communicating the employer’s opinion about religious or political matters, or (b) listen to or view communications (including electronic communications) whose primary purpose is communicating the employer’s opinion about religious or political matters.

The bill preserves specific employer/role-based exceptions. It allows employers and specified entities to communicate information required by law, to provide job-duty–necessary information, and permits certain participation/communications in higher-education coursework, academic programs, and related symposia. It also allows casual, non-required conversations between employees and employer representatives, and applies a limitation for requirements directed only at managerial/supervisory employees. Additionally, the protections do not apply to certain religious corporations/entities/associations/educational institutions/societies that are exempt from Title VII of the Civil Rights Act of 1964 (under specified federal law) or from certain Massachusetts provisions, with respect to speech on religious matters to employees whose work is connected to the organization’s undertaken activities.

Politically relevant scope is clarified by the added definition of “political matters,” which includes matters relating to elections for political office, political parties, proposals to change legislation and regulation, and decisions to join or support political, civic, community, fraternal, or labor organizations. “Religious matters” is defined to cover religious affiliation and practice and decisions to join or support religious organizations or associations.

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 establishes new restrictions on employer use of non-compete agreements in New York by creating Labor Law § 191-d. It defines “non-compete agreement” as any clause in an agreement between an employer and a “covered individual” that prohibits or restricts the individual from obtaining employment after leaving the employer, and defines “covered individual” broadly as those economically dependent on, and obligated to perform duties for, another person; it excludes “highly compensated individuals” (set at an annual average cash compensation of at least $500,000, calculated from the individual’s most recent W-2/K-1 statements and adjusted each year, beginning in 2026 per the bill’s CPI-based method) from coverage. It also defines “health related professional,” listing specified licensed health professions (e.g., physician, nurse, pharmacist, psychologist, and others).

The bill prohibits employers (and their agents/officers) from seeking, requiring, demanding, or accepting non-compete agreements from covered individuals and health related professionals; any such agreement sought, required, demanded, or accepted after the section’s effective date is declared “null, void, and unenforceable.” It also creates a private enforcement mechanism: covered individuals and health related professionals may bring a civil action for violations, within a two-year limitations period measured from the later of specified trigger events (e.g., when signed, when the individual learns of the agreement, when the relationship ends, or when enforcement steps are taken). Courts are authorized to void the non-compete and order appropriate relief including injunctive relief, liquidated damages, and other forms of monetary relief (including lost compensation, compensatory damages, and reasonable attorneys’ fees/costs).

The bill sets liquidated damages at an amount not more than $10,000 per covered individual or health related professional and requires that liquidated damages be awarded to every affected person in addition to other remedies. It clarifies that the section does not limit other legal protections relating to agreements that establish fixed terms/exclusivity during employment, prohibit disclosure of trade secrets, or prohibit disclosure of confidential and proprietary client information, or prohibit client solicitation—provided those agreements do not otherwise restrict competition in violation of § 191-d. It further (i) states it does not affect enforcement of Labor Law § 202-k and (ii) preserves enforceability of non-compete provisions in certain business sale contexts (sale of goodwill or sale/disposition of a majority ownership interest by a qualifying equity holder, including specified 15%+ ownership thresholds).

It also adds several additional conditions for any non-compete that is otherwise permissible/enforceable under the section: it must satisfy New York common-law enforceability factors (reasonableness in time/geography/scope, no undue hardship, no harm to the public, protection of legitimate business interests, and restrictions no greater than necessary), cannot exceed a one-year restriction period for the time-reasonableness requirement, and must provide for salary during enforcement. Choice-of-law/venue clauses attempting to avoid or limit § 191-d’s requirements are rendered unenforceable for covered individuals who are New York residents or employed in New York (including certain remote workers who report to a NY worksite/office or NY-based supervisor) for at least the 30 days immediately preceding cessation. Employers must inform employees of protections via conspicuously posted notice. Separately, it adds Labor Law § 45 requiring the Department of Labor to develop the notice for employers to distribute and for posting on the department’s website. The act takes effect 30 days after becoming law; § 2 (the new § 45 notice requirement) takes effect 180 days after becoming law, with authorization to adopt necessary implementation rules in time for the effective date.

The bill amends Tennessee Code Annotated to delete a specific subsection from the health care title. Specifically, it removes subsection (g) of Tennessee Code Annotated § 63-1-160.

It provides that the act becomes effective upon becoming a law, based on the public welfare requiring immediate implementation.

FULL SUMMARY

The bill changes Tennessee statutory provisions governing physician employment restrictions—mainly in T.C.A. § 63-6-204 and T.C.A. § 68-11-205—by removing multiple “other than” carve-outs for certain physician specialties and deleting specific related limitations, while adding clarifying provisions that do not require a particular employment relationship for specified specialties if other requirements are met.

In T.C.A. § 63-6-204, the bill deletes multiple listed subdivisions and subsection (l) and removes (1) language excluding certain specialties from the definition of “physician” for purposes of § 63-6-204(d), (2) references excluding radiologists, anesthesiologists, pathologists, or emergency physicians, and (3) a specialty-specific restriction tied to physician employees of certain faculty practice plans practicing only within the institutions where they were employed as of May 30, 1997. It also narrows a cross-reference in § 63-6-204(h)(5)(A) by replacing “specialties of ophthalmology, pathology, anesthesiology and/or emergency medicine” with only “specialty of ophthalmology.”

The bill adds a new subsection to § 63-6-204 stating that the section does not require a particular employment relationship for employing a radiologist, anesthesiologist, pathologist, or emergency physician, so long as the physician otherwise complies with the chapter; it defines “employment relationship” to include both direct employment and employment via an agreement with a third party.

Similarly, for T.C.A. § 68-11-205, the bill removes multiple specified subdivisions and subsection (g), deletes “other than radiologists, anesthesiologists, pathologists, or emergency physicians” language from § 68-11-205(b)(1) and (c)(1), and adds a new subsection providing that § 68-11-205 does not require a particular employment relationship for employing a radiologist, anesthesiologist, pathologist, or emergency physician by a hospital licensed under the chapter or an affiliate, provided the employment otherwise complies with the part; it likewise defines “employment relationship” to include direct employment and employment through a third-party agreement. The act takes effect July 1, 2025.

The bill changes a Tennessee health care deadline by amending Tennessee Code Annotated § 63-6-204(f)(2)(A)(iv), replacing the requirement that something occur “within ten (10) business days” with “within thirty (30) business days.” It applies to the specific action governed by that subsection, effectively extending the allowed response/processing timeframe. The bill takes effect upon becoming law, based on the stated public welfare.

The bill changes the timeline for reporting certain health care–related information required under Tennessee law. Specifically, Tennessee Code Annotated § 63-6-204(f)(2)(A)(iv) is revised by replacing the existing requirement that a report be made within ten (10) business days with a new deadline of within thirty (30) business days.

The bill provides that it takes effect upon becoming a law, based on the public welfare.

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 a new Ohio chapter (R.C. 4119.01–4119.04) addressing employment or worker agreements that restrain a worker from engaging in lawful work or operating a business after the employment relationship ends. It defines “employer” broadly as a person hiring or contracting with a worker, and “worker” broadly to include employees, independent contractors, interns/externs/volunteers/apprentices, sole proprietors serving clients/customers, and individuals providing services through a business or nonprofit entity or association.

Beginning on the effective date, the bill prohibits employers from entering into, attempting to enter into, presenting as a term of hire, or attempting to enforce agreements (or parts of agreements) that prohibit, penalize, or function to prevent a worker from seeking or accepting work or operating a business after the relationship ends. The prohibition includes, among other things: (1) noncompetition arrangements restricting working for another employer for a time period or in a geographic area or restricting similar work capacity; (2) agreements requiring payment for lost profits/lost goodwill or liquidated damages because the worker terminates the relationship; (3) agreements imposing fees/costs on termination (including replacement hire fees, retraining fees, and reimbursement of immigration/visa-related costs, and a “bondage fee” reference); and (4) agreements requiring workers who terminate to reimburse the employer for specified expenses incurred for training/orientation/evaluation or other services intended to build or improve job skills. Agreements violating this prohibition that are entered into, modified, or extended on or after the effective date are void, but the chapter contains exceptions allowing certain debt forgiveness/benefits after a specified work period and does not limit or prohibit loan repayment assistance/forgiveness programs provided by federal, state, or local government.

The bill also restricts choice-of-law and dispute-venue provisions for certain workers: with respect to agreements entered into, modified, or extended on or after the effective date, a worker who primarily resides and does business in Ohio cannot be required (as a condition of employment) to agree to provisions requiring adjudication of claims arising in Ohio in an out-of-state venue/forum or depriving the worker of substantive legal protections under Ohio law for controversies arising in Ohio. Agreements violating this restriction are void and disputes must be adjudicated in Ohio under Ohio law. A limited carve-out applies where the worker is individually represented by legal counsel in negotiating the agreement and—at the worker’s option—designates the venue/forum and/or choice of law; the carve-out excludes situations where counsel is paid for by, or selected based on, the employer’s suggestion.

Enforcement is provided through a private right of action and administrative complaint pathways. A worker or prospective worker may sue an employer for violations; if the worker prevails, the court must award costs and reasonable attorney’s fees and may award actual damages, punitive damages up to $5,000, and/or injunctive relief. The worker may alternatively file complaints with the Ohio Attorney General, who must investigate and may sue on the worker’s behalf if likely violations are found; if the Attorney General prevails, costs and reasonable attorney’s fees are awarded to the Attorney General and other specified prevailing party(s). The worker may also file with the Director of Commerce, who investigates and forwards findings to the Attorney General; the Attorney General may then sue. The Attorney General and Director of Commerce must coordinate responsibilities via a written agreement, and the bill states it does not limit rights/obligations under state or federal laws that directly regulate the manner, content, or terms of financial transactions with respect to consumers.

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.

FULL SUMMARY

The bill amends Welfare and Institutions Code Section 9120 to require Aging and Disability Resource Connection (ADRC) programs to provide disaster and emergency preparedness training/community education for older adults and people with disabilities, aimed at improving emergency preparedness and promoting safety before, during, and after natural disasters and other emergency events.

The amended ADRC service requirements retain the existing ADRC framework but modify the specific training duty: the disaster/emergency preparedness component is positioned as “training community education” designed to help achieve the goals of informing older adults and people with disabilities regarding emergency preparedness and safety. The education/training is authorized to use existing emergency preparedness and response tools developed by specified state entities (including the Office of Emergency Services and the California Department of Aging) and other relevant community partners, and it must raise awareness of available resources and guidance, including local alert systems, local emergency plans, information from the local fire department, emergency transportation and evacuation resources, and information related to utility services during emergencies and natural disasters.

No other Section 9120 provisions shown in the text are substantively changed: ADRC programs continue to be jointly operated by area agencies on aging and independent living centers, administered by the California Department of Aging in collaboration with specified state departments, and required to provide enhanced information/referral, options counseling, short-term service coordination, and transition services, along with geographic coverage and public information about program services. The section continues to require the California Department of Aging to develop and implement an ADRC best-practices model (with advisory committee input) and to make implementation contingent on an appropriation.

FULL SUMMARY

The bill makes changes to the Hospital Licensing Act, specifically to (1) the statutory definition of “hospital” in Section 3 and (2) the hospital pathogen prevention and control requirements for “pathogens of epidemiological concern” (including MDROs) in Section 6.23.

In Section 3, the bill revises the definition of “hospital” by adding an explicit category for, “on and after January 1, 2023, a rural emergency hospital,” tied to the federal definition under 42 U.S.C. § 1395x (as reflected by subsection (kkk)(2) of Section 1861 of the federal Social Security Act). Section 3 also sets a licensing framework for what is included in the “hospital” definition and clarifies several exclusions (e.g., certain facilities licensed under other health-care statutes, facilities maintained by government or universities with authority/standards, facilities using spiritual prayer exclusively, and an Alzheimer's disease alternative health care model).

In Section 6.23, the bill strengthens and clarifies statewide hospital infection-control obligations for MDROs and other pathogens of epidemiological concern. It requires each hospital to develop and implement comprehensive interventions to prevent and control such pathogens, considering CDC guidance and specified infectious disease and infection-control organizations. It also requires the Department of Public Health to adopt administrative rules requiring hospitals to conduct an annual, facility-wide infection control risk assessment and to enforce hand hygiene and contact precaution requirements. Within 12 months after the bill’s effective date, each hospital must adopt a minimum-content policy that (1) includes a facility risk assessment identifying relevant pathogens using surveillance-informed probability, potential impact, and mitigation measures, and (2) includes evidence-based procedures to identify colonized/infected patients and prevent transmission to other patients and health care workers. If a hospital identifies a patient with a pathogen of epidemiological concern through appropriate testing, the bill requires reporting the patient to the U.S. Department of Health and Human Services or to the National Healthcare Safety Network (as required by the Department of Public Health or CMS).

Finally, the bill repeals the MRSA Screening and Reporting Act, with an effective date stated as January 1, 2027.

FULL SUMMARY

The bill amends New York’s Executive Law regarding the use of disaster emergency response personnel and non-state resource providers, and it adds two new statutory sections establishing the state’s authority to enter specific emergency management assistance compacts.

First, it updates Executive Law § 29-b(1) (State use of disaster emergency response personnel and non-state resource providers) to: (1) use gender-neutral references (“their” rather than “his or her”); (2) clarify that the governor may deploy non-state resource providers to another compact member jurisdiction under the applicable compact; and (3) specify that when authorized and deployed by the legally designated state official(s), non-state resource providers are deemed agents of the state for purposes of deployment and receive the rights/benefits provided to state resource providers under the compact, subject to the requesting state’s terms and conditions—while prohibiting such providers from offering assistance to, or requesting assistance from, another compact member jurisdiction. The bill also maintains the role of the Division of Homeland Security and Emergency Services as the coordinator/facilitator for offers and requests and reimbursement, including that reimbursement does not begin until the division receives payment from the requesting compact member jurisdiction.

Second, it adds Executive Law § 29-k (“Northern emergency management assistance compact”), authorizing the state, through the governor, to enter the Northern Emergency Management Assistance Compact (P.L. 112-282, ratified by Congress January 14, 2013). It provides that the compact is deemed ratified by the legislature upon the governor’s certification to specified state officers that New York has entered into the compact.

Third, it adds Executive Law § 29-l (“International Emergency Management Assistance Compact”), authorizing the state, through the governor, to enter the International Emergency Management Assistance Compact set forth in an emergency management assistance memorandum of understanding (executed July 18, 2000) covering specified New England states and Canadian provinces, as authorized by a U.S.-Canada emergency planning and management agreement. As with § 29-k, the compact is deemed ratified by the legislature upon the governor’s certification to specified state officers that New York has entered into the compact. The act takes effect immediately.

FULL SUMMARY

The bill establishes a statewide air medical services program within the Hawaii Department of Health’s emergency medical services and injury prevention system branch to provide governance, coordination, oversight, quality improvement, and disaster readiness for emergency aeromedical and interfacility air medical transport.

To staff the program, the bill creates three permanent, recurring positions (exempt from chapter 76): (1) a state air medical director who must be a physician licensed in Hawaii with experience in emergency medicine, trauma care, or critical care transport and who provides statewide clinical and medical oversight; (2) a state air medical program manager responsible for program administration, policy development, system planning, and interagency coordination; and (3) an air medical coordinator to support operational coordination, data oversight, compliance monitoring, performance improvement, and coordination with licensed air medical providers, county EMS agencies, hospitals, and emergency management partners. It further authorizes the program—under the director of health—to provide statewide clinical governance and medical direction, develop/adopt statewide air medical policies and clinical protocols consistent with nationally recognized standards, coordinate air medical services across counties, oversee provider participation in data-based quality improvement, support disaster preparedness/response/recovery activities, and coordinate with a range of public and private partners.

As a condition of licensure, all air medical providers operating in Hawaii must cooperate with and participate in statewide air medical coordination, data reporting, and quality improvement activities as required by the department. The bill also authorizes the program to coordinate with the state emergency medical services advisory committee and to establish advisory or quality improvement committees as needed.

The bill requires the department to establish and assess annual air medical ambulance licensure and accreditation fees for all air medical providers. Fees must be reasonable, non-refundable, and sufficient to cover specified statewide administrative and oversight functions (including program administration/oversight, licensure and enforcement activities, statewide coordination and quality improvement, and data collection/reporting). Fees collected are deposited into the emergency medical services special fund (HRS §321-234) and may be used solely to administer and support the statewide air medical services program, its staff, and emergency management coordination functions. Finally, it amends HRS §321-234(b) to add the fee-based distribution/use language and strikes prior fee distribution text; the bill takes effect upon approval.

FULL SUMMARY

The bill establishes a statutory definition of “state of preparedness” as a Governor-declared condition under which the threat or danger of a credible emergency or disaster is sufficiently severe and extensive to justify Commonwealth disaster-preparedness assistance to supplement local and relief-organization preparedness and to prevent or lessen anticipated damage, loss, hardship, or suffering.

It directs the Department of Emergency Management to assess the feasibility and impact of creating a program that prioritizes prevention and mitigation of damage, loss, hardship, or suffering caused by the anticipated effects of an imminent emergency that requires a gubernatorial declaration of a “state of preparedness,” or that is an emergency not warranting a gubernatorial declaration of a state of emergency. The assessment must include: (1) criteria for deciding when the Department should respond even without a gubernatorial declaration of a state of emergency; (2) procedures for procurement, maintenance, and replenishment of materials, equipment, and supplies (in needed quantities and locations) to ensure readiness and protect life, property, and economic well-being before and during such emergencies; (3) the feasibility of seeking reimbursement from persons causing or contributing to the emergency or disaster for Department expenses related to protection, relief, and recovery; and (4) cost estimates covering personnel, administrative, and equipment expenses for the Department and, where applicable, other state agencies, political subdivisions, or other entities responding to emergencies not warranting a gubernatorial declaration of a state of emergency.

The bill requires the Department to submit a report containing its findings and recommendations to the Governor and specified legislative committee chairs no later than November 1, 2026.

FULL SUMMARY

The bill directs the Virginia Department of Emergency Management to assess whether it should develop a program that prioritizes prevention and mitigation of damage, loss, hardship, or suffering from an imminent emergency that (a) would trigger a gubernatorial “state of preparedness” declaration or (b) would not warrant a gubernatorial declaration of a state of emergency.

It defines “state of preparedness” as the Governor’s judgment that a credible emergency or disaster is of sufficient severity and magnitude to warrant Commonwealth disaster-preparedness assistance to supplement localities’ and relief organizations’ efforts and to pre-position available resources to prevent or alleviate threatened or caused damage, loss, hardship, or suffering.

In conducting the assessment, the Department must evaluate and develop recommendations on (1) criteria for determining when an emergency warrants Department response when no gubernatorial declaration of a state of emergency is warranted; (2) procedures for procurement, maintenance, and replenishment of materials, equipment, and supplies (including quantities and locations) to ensure readiness and to protect life, property, and the Commonwealth’s economic well-being prior to and during a state of preparedness declaration or in emergencies not warranting a state of emergency; (3) the feasibility of seeking reimbursement from persons causing or contributing to an emergency or disaster for Department protection, relief, and recovery expenses; and (4) cost estimates, including personnel, administrative, and equipment expenses, that the Department (and possibly other state agencies, political subdivisions, or other entities) would incur when responding to an emergency not warranting a gubernatorial declaration of a state of emergency.

The Department must submit a report with findings and recommendations to the Governor and the specified legislative committees by November 1, 2026.

FULL SUMMARY

The bill establishes a new statutory subdivision in RSA 151 governing transfer practices for patients receiving emergency medical care at freestanding hospital emergency facilities (FHEFs). It requires FHEFs to give patients (or legal representatives) the opportunity to choose the receiving acute care hospital when a medically necessary transfer is required and the receiving hospital can meet the patient’s needs, and it prohibits FHEFs from directing transfers exclusively to the parent/affiliated hospital except when required by federal law. It also requires documentation of the patient’s transfer choice in the medical record and directs that, if the patient cannot choose, the FHEF must arrange transfer to the closest appropriate receiving hospital able to address the patient’s needs.

The bill also establishes prohibited practices for FHEFs and their owners/operators: they may not condition treatment or discharge on transfer to an affiliated/parent hospital based on insurance or lack of insurance; they may not engage in steering, coercion, or misleading communications intended to limit transfer choice; and they may not execute EMS provider policies/contracts that require or encourage exclusive transfers to an affiliated/parent hospital.

The bill requires the Department of Health and Human Services commissioner to issue interim rules under RSA 541-A:19 to implement these provisions and to adopt final rules by June 30, 2027. It provides for enforcement through referral of a pattern of violations to the Department of Justice, treating such violations as an unfair or deceptive act or practice under RSA 358-A:2, with rights and remedies under RSA 358-A available for enforcement.

The act takes effect upon passage.

FULL SUMMARY

The bill establishes updated requirements for how California county behavioral health directors develop designation and training procedures for professionals performing functions under Welfare and Institutions Code Section 5150.

It changes Section 5121(a) by requiring the county behavioral health director to “develop procedures for establishing and implementing” (rather than only “develop procedures for”) county designation and training, and explicitly requires the procedures to include: (1) the license types, practice disciplines, and clinical experience of eligible professionals; (2) initial and ongoing training and testing requirements; (3) application/approval processes, including timelines for initial designation and procedures for renewal; and (4) processes for monitoring and reviewing designated professionals’ compliance with state law, regulations, and county procedures.

It adds/clarifies related operational requirements: a county behavioral health director may develop training for the procedures. If a director denies or revokes an individual’s designation, the director must provide written notice to the requestor and to the individual, stating the reasons. It specifies that designated members of a mobile crisis team and designated professional persons are not prohibited from transporting a person taken into custody under Section 5150.

For the County of Sacramento, if it develops procedures under subdivision (a), the bill requires the director to issue a written policy by April 1, 2022 covering the minimum topics in subdivision (a)(1)–(4), and requires designation (upon the City of Sacramento’s written request and meeting policy requirements, including completion of any director-provided training) of individuals employed by the City who are also mobile crisis team members or professional persons. The bill also requires that an emergency physician be included as an eligible practice discipline when developing and implementing designation/training procedures under subdivision (a)(1), while stating this does not alter the overall processes for designation and revocation for all eligible professionals. It defines “emergency physician” as specified (a physician and surgeon providing medical screening and treatment in an emergency department of a general acute care hospital licensed under specified Health and Safety Code provisions). The bill clarifies that it does not require counties to designate every individual meeting subdivision (a) requirements and does not limit counties’ authority to establish consistent criteria/procedures. Finally, it provides that if the Commission on State Mandates determines the act creates state-mandated costs, reimbursement to local agencies and school districts must be made under the Government Code mandate reimbursement provisions.

FULL SUMMARY

The measure establishes numerous conforming state statutory changes tied to federal Medicaid reforms in Public Law 119-21 (H.R. 1), expands or recasts health and behavioral health programs, and creates/updates several funds, reporting systems, and regulatory frameworks. It also makes targeted changes to provider licensing and service coverage rules across multiple health systems (Medi-Cal, health plans/insurers, hospitals, home health agencies, substance use disorder facilities), plus updates to criminal-justice-related mental health placement procedures and some public-health data sharing and reporting structures.

It also makes a series of substantive statutory revisions to Medi-Cal eligibility administration and immigration eligibility rules, including: (1) shifting when certain groups are subject to more frequent (6-month) redeterminations; (2) adding work/community-engagement eligibility requirements for specified individuals beginning no sooner than January 1, 2027, including exemptions/deemed-compliance and notice/cure and fair hearing procedures; (3) requiring counties to accept specified signature methods for renewal forms; (4) requiring the Department of Health Care Access and Information (HCAI) to create a publicly posted data dashboard (excluding personal identifiers) tracking H.R. 1 impacts such as redeterminations, disenrollments, work/community engagement outcomes, exemptions, and hardship reasons; (5) modifying retroactive coverage rules for applications; (6) requiring a regular process to obtain address information and prevent simultaneous enrollment in multiple states; and (7) revising non-citizen eligibility restrictions and service limitations—expanding full-scope eligibility for certain immigration statuses with service limitations, delaying dental ineligibility to no sooner than July 1, 2027, and setting monthly premiums (with upper/lower bounds) to be included in the Governor’s May Revision.

Beyond Medi-Cal eligibility, it establishes or changes health coverage requirements for menopausal symptoms: it requires health care service plans (and separately health insurance policies) to cover FDA-approved treatments for menopausal symptoms as medically necessary; it requires programs to provide current menopause information and annual menopause assessments (with opt-out), biannual notices listing covered items/services, provider reimbursement policies, and utilization review criteria based on current generally accepted menopause care standards—effective for plan/policy coverage and program requirements beginning in 2027. It creates continuing-education credit rules for physicians/osteopathic physicians and related course-hour adjustments for nurse practitioners/physician assistants tied to perimenopause/menopause/postmenopause coursework and directs boards to consider additional menopause-related courses.

The bill also: (1) changes CalAIM timelines by extending the CalAIM initiative (subject to federal approvals) to December 31, 2031 and requires additional behavioral health delivery structure changes (single PIHP for counties participating in Drug Medi-Cal delivery system); (2) extends CalAIM-related behavioral health delivery contract requirements; (3) delays certain implementation deadlines for data exchange framework compliance for community/intermittent/rural health clinics; (4) adds new statewide “Health Care Data” chapter duties for HCAI to compile public quality-of-care report card data and to produce biennial consumer assistance center reports plus odd-year analyses; (5) recasts and expands ADAP Rebate Fund allowed uses and creates a Hospital Fair Pricing Penalties Fund; and (6) updates multiple licensing and enforcement frameworks, including new/changed licensing staffing and licensing-application requirements for home health agencies (administrator/director roles, information submission timelines, verification duties, transfer/ownership restrictions, license transfer prohibition, moratorium on new licenses/branch offices with exceptions), changes to alcohol/other drug facility terminology (detoxification recast as withdrawal management, withdrawal-management guidance/rules, detoxification-only license expiration on July 1, 2027), and new hospital “distinct part/composite distinct part” application criteria, including limits and resident segregation prohibitions.

It further modifies state-level criminal-legal procedures for outpatient/forensic conditional release decisions by renaming and revising independent evaluation panel processes (including extending certain provisions indefinitely), and amends welfare and institutions code behavioral health allocation planning and minimum expenditure requirements (starting in later fiscal years) for counties, including new methodology for minimum spending levels, sanctions/withholding processes, and additional reporting data elements. Finally, it includes appropriations authorization tied to the Budget Act of 2025, states it takes effect immediately, and contains constitutional “state mandate no reimbursement” provisions and public-access limitation findings related to confidentiality and personal medical information.

FULL SUMMARY

The bill establishes the Current Operations Appropriations Act of 2026, providing maximum appropriations for FY 2026–2027 within the State Budget Act framework and requiring year-end reversion of unneeded amounts to the appropriate fund unless otherwise provided by law. It sets General Fund current operations and net appropriations for specified agencies and programs, defines how “requirements” amounts combine agency receipts and appropriations, and establishes General Fund availability by itemizing prior balances, revenue forecasts and adjustments, required and discretionary revenue reservations, and a remaining unappropriated balance. It authorizes additional nonrecurring transfers to the Savings Reserve and creates an IT “Cash Flow IT Reserve” and several other reserves (including IT, Federal Infrastructure Match, Stabilization and Inflation, and multiple revenue reserves), clarifying that described reserved funds are “reservations not appropriations” and specifying transfers to agencies and budget codes for designated IT projects. The bill also appropriates State Highway Fund and Highway Trust Fund monies for FY 2026–2027, aligns highway “availability” inputs to budget development, and sets general rules for availability and appropriation of base budget items, agency receipts for statutorily required salary/benefit increases, and handling of receipts exceeding appropriations.

The bill directs statutory changes across multiple budget and policy areas, including revisions to education funding allocation mechanisms and grant structures (such as lottery allocations and school capital fund priorities, including added prioritization for certain career and technical education centers), specified nonrecurring ARPA allocations for a children’s hospital with a required disbursement timeline, and lottery and other education fund allocation updates for the biennium. It rewrites multiple State Budget Act and related provisions, including open data accessibility requirements, budget recommendation and budget adjustment procedures, continuation rules for grants when a current operations act is not in place, reversion and receipt-handling mechanics (including IT-related nonreversion rules tied to project status), and other statutory changes including the repeal of a named provision. The bill establishes detailed “directed grant” governance rules (timing tiers, reporting to the Fiscal Research Division, reversion constraints, and recipient restrictions), limits state-funded portions of nonprofit salaries, requires vacant position reductions by eliminating vacant positions with a December 1, 2026 reporting requirement, and creates or updates several reserve and transfer rules for cash flow and reserve interactions. It further makes programmatic additions for areas such as disaster recovery, education initiatives and governance/reporting requirements, and creates a Child Welfare Case Escalation Team in DHHS with required county coordination and training/automation directives. In addition, it creates a new entertainment ticket sales and resale regulatory scheme by establishing Article 9 of Chapter 75, including definitions, secondary market price transparency requirements, limits on speculative ticket sales and resale timing/presale activity, anti-circumvention rules, and enforcement as an unfair trade practice with civil penalties and an applicability date for covered tickets sold or resold on or after October 1, 2026. The bill also restructures numerous boards and commissions by changing membership and governance provisions, clarifies local water enterprise authority and definitions, establishes a Complex Family Financial Cases court procedure, creates a Council of District Attorneys within the Judicial Branch and transfers relevant operations and budgeting into it, updates sex offender restrictions related to seasonal child care camps and certain proximity limits, changes DMV registration to emphasize electronic notices and records with an October 1, 2026 effective date, creates a DMV in-home driver’s license renewal pilot in Forsyth County with specified timing and fee limits, and revises medical board fee schedules effective October 1, 2026. It requires an OSBM (consulting with DHHS) RFP and contract for a third-party healthcare facility study with legislative reporting deadlines and appropriates $1 million for that study.

The bill makes substantial tax, revenue, and insurance-related regulatory changes. It revises North Carolina personal income tax rate schedules and adds a trigger-based reduction mechanism tied to total General Fund revenue thresholds, and it allows a deduction for wagering losses under specified federal Code provisions for taxable years beginning on or after January 1, 2025. It expands hospital sales tax refund eligibility rules by clarifying what qualifies as “direct purchases” while excluding multiple categories (including specified utilities and services), establishes specific written-request documentation and due dates, preserves a $31,700,000 annual statewide per-entity cap, and clarifies eligibility and grouping rules that treat certain hospital system components as separate entities for cap purposes. It repeals the existing datacenter electricity exemption for sales of electricity used at an eligible internet datacenter and replaces it with a new exemption for electricity used at a qualifying datacenter, including forfeiture triggers tied to investment levels and a requirement to pay past taxes avoided plus interest within 30 days of forfeiture. It changes the insurance regulatory charge structure and gross premiums tax rates (including prepaid health plan and workers’ compensation/other insurance contract rate alignment), provides effective dates beginning July 1, 2026 for related statutory alignment and January 1, 2027 for installment-payment rules, and directs how preexisting Insurance Regulatory Fund money must be used. It revises vapor-product and consumable-product licensing/registry requirements by creating a public directory, restricting retail sale to listed products after sell-off periods, requiring enforcement mechanisms including compliance checks and seizure/forfeiture procedures, adjusting license revocation grounds, and creating a youth-access restriction for specialty retailer of vapor products. It increases the interactive sports wagering operator excise tax rate from 18% to 23% and alters proceeds distribution by adding a new university athletic-department “Class III” distribution tied to men’s football program subdivision criteria while maintaining capped allocations to a Major Events Fund and distributing remaining proceeds to the General Fund under revised effective dates. It also clarifies that net Amateur Sports fund proceeds do not revert. The bill adds a new 6% tax on prediction markets based on operators’ net trading fee revenue apportionable to North Carolina, with annual returns and recordkeeping requirements. It clarifies present-use value trust qualification rules and provides a time-limited refund opportunity for certain owners who lost qualification on or after January 1, 2026 and before enactment. It creates a Sampson County-only local sales and use tax framework for public education after an advisory referendum, limiting proceeds strictly to public school capital outlay and operating expenses and preventing overlap with other county taxes under specified provisions. It also rewrites Brunswick fire district fee caps with a first-stage schedule and a second-stage recast effective July 1, 2027, while retaining limits tied to the estimated cost of providing services and keeping the 75% reduction for certain properties beyond defined distance and fire insurance rating conditions.

The bill further establishes or revises multiple economic development and environmental permitting mechanisms. It adds a Community Development Block Grant framework with yearly reporting by the Department of Commerce and rules for proportional reductions/increases if federal funding changes after enactment. It creates a new Micro-Budget Production Grant Fund in the Department of Commerce, sets eligible qualifying expense ranges and maximum grant limits with bonus structures tied to resident pay and filming-location tiers, prohibits conditioning grants on distribution agreements, limits annual combined liability, and requires pre-promulgation public notice and a comment period before implementing guidelines. It revises the Film and Entertainment Grant Fund’s fee caps and maximum ceilings, updates definitions and limits, and adds a multi-production bonus structure, with applicability for grants made on or after July 1, 2026. It modifies environmental and administrative provisions by extending and revising incentives and deadline/reversion rules for DEQ-related projects and grants/loans, adjusts interbasin transfer study and moratorium rules, creates new FAST-41 participation requirements for DEQ critical energy infrastructure permitting coordination with deadlines and reporting (while prohibiting waiving substantive permitting standards), adds DEQ-to-Utilities Commission reporting on water/wastewater permit violations and authorizes related investigations and remedial orders, and creates an AI Environmental Permit Review pilot program with vendor qualification, reporting, and data security/hosting constraints. It caps elevator construction permit fees for eligible applicants at no more than $25,000 and provides reimbursement for amounts paid above the cap when eligibility conditions are met, and it creates a Building Codes and Interpretations Bureau with a State Building Code Regulatory Fund and a new regulatory fee system with quarterly remittance and enforcement procedures.

FULL SUMMARY

The bill establishes new pediatric patient protection requirements for Florida hospitals that operate emergency departments by creating new subsections in s. 395.1012 (Patient safety). It requires each such hospital to develop and implement evidence-based policies and procedures for pediatric emergency care covering, at minimum, triage, measuring and recording vital signs, weighing and recording weights in kilograms, calculating medication dosages, and using pediatric instruments. It also requires at least annual training on these policies and procedures, including instruction on the use of pediatric instruments (as applicable to the hospital’s licensure type) using clinical simulation and conducting at least annual emergency department drills that simulate emergency situations.

The bill also requires each hospital emergency department to designate a “pediatric emergency care coordinator” (a physician, physician assistant, nurse, or paramedic with specified Florida licensure categories). The coordinator must be responsible for implementing and ensuring fidelity to the pediatric emergency care policies and procedures adopted under the new requirements. In addition, the bill authorizes, under specified conditions, hospitals with an emergency department to conduct the National Pediatric Readiness Project’s Open Assessment during years when the National Pediatric Readiness Assessment is not conducted.

The bill requires rulemaking related to pediatric readiness and emergency management planning by amending s. 395.1055. It directs the agency to adopt rules that establish minimum standards for pediatric patient care in hospital emergency departments, in consultation with the Florida Emergency Medical Services for Children State Partnership Program, including (at minimum) the availability and immediate access to pediatric-specific equipment and supplies. It also amends the existing comprehensive emergency management plan rule requirements to ensure pediatric and neonatal patient needs are addressed in plan components and that plan review and approval procedures include specified agencies and volunteer organizations, with the local emergency management agency completing review within 60 days.

Finally, the bill amends s. 408.05 (Florida Center for Health Information and Transparency) by adding a new function requiring the agency to collect and publish overall assessment scores from the National Pediatric Readiness Assessments submitted by hospitals. Specifically, the agency must collect overall assessment scores from the Florida EMS for Children State Partnership Program by December 31, 2026, and each subsequent December 31 during years in which the National Pediatric Readiness Assessment is conducted; publish each hospital’s overall score by April 1, 2027, and each subsequent April 1 when applicable (including a comparison to the national average score when available); and collect and publish no more than one overall score per hospital per year for assessments conducted under the relevant statutory subsections, with comparison to the hospital’s most recently published score. The act takes effect July 1, 2026.

FULL SUMMARY

The bill appropriates General Fund money for fiscal year 2027 for Commonwealth departments, agencies, and institutions, including supplemental and deficiency budgets, subject to existing public-funds disbursement laws for the fiscal year ending June 30, 2027. It requires nondiscrimination and equal opportunity measures for all spending funded under the act, including specific internal steps by agencies and equal opportunity steps covering hiring, promotion, demotion/transfer, recruitment, layoff/termination, compensation, and training. It declares revenue sufficiency for fiscal year 2027 and directs the Comptroller to maintain separate quarterly accounts of actual receipts by revenue source and fund and to report comparisons to projections, along with additional reporting of other revenue sources for the budgeted funds. The bill also makes line-item appropriations for numerous entities and establishes additional reporting and operational conditions tied to appropriations, including performance/outcome reporting, restrictions on certain fund transfers, earmarks for specified purposes and organizations, minimum spending requirements for defined initiatives, and quarterly or annual reporting to legislative committees.

To govern interagency service spending, it creates a Section 2B mechanism that authorizes listed agencies to expend amounts for services provided to other listed agencies, while requiring corresponding fund transfers into an intragovernmental service fund, setting rate principles consistent with OMB Circular A-87, prohibiting expenditures that would leave the intragovernmental fund in deficit at fiscal year 2027 close, and directing that any remaining intragovernmental balance at year-end be transferred to the General Fund. It appropriates enumerated federal grants from the General Federal Grants Fund across multiple agencies and directs that federal funds received above appropriated amounts be expended only as authorized under the specified ch. 29 provision. It also authorizes operating transfers from the General Fund to specified trust funds with limits on applicability of certain reduction/allotment mechanisms without explicit General Court authorization and requires transfers to follow a Comptroller transfer schedule. For education funding, it sets Chapter 70 school aid distributions for fiscal year 2027, including lottery-related compliance requirements, foundation budget calculation assumptions (including low-income methodology and special education percentages for vocational versus non-vocational schools), formula adjustments and statewide targets, limits on certain “non-operating” district payments, and a municipality-by-municipality distribution table for the defined aid components.

The bill makes multiple substantive statutory changes across several chapters, including designating the Massachusetts National Guard museum in Salem as the Commonwealth’s official military museum. It replaces the existing Thomas P. Kennedy Spinal Cord Injury Trust Fund provisions by creating a non-budgeted special revenue fund administered by the Treasurer, establishing revenue sources including a $50 driving-license reinstatement surcharge with increasing amounts for successive reinstatements, restricting use of funds to medical cure research and clinical trials for spinal cord injury without further appropriation, and creating an advisory board to review research proposals. It modifies the regulatory process for a named office by requiring legislative submission and providing for presumed approval unless disapproved within a defined period, and it revises inspector general procedures and language relating to witness/testimony handling. It restructures sports wagering revenue allocation by creating a Sports Wagering Fund and directing specified revenue transfers to multiple named funds, and it updates gaming-related trust contribution formulas by revising the assessment to 4.5% of gross gaming revenue with a corresponding daily assessment. It changes election and candidate-information administration rules, including what candidate identifying information is printed, limits on public-record access to certain residential address information with a certification process to obtain more specific address data, and updates related definitions and ballot/nomination print requirements. It creates a consumer “negative option” contract rule that bars targeted Commonwealth negative option products from failing to provide an immediately effective, easy-to-use cancellation mechanism and from failing to give required written notice before the cancellation deadline for longer-duration negative option products, authorizes Attorney General regulations, and treats violations as unfair/deceptive under ch. 93A. It expands and refines Medicaid-related contractual and rebate negotiation provisions, modifies parent-notice service methods in care proceedings, updates juvenile criminal procedure/evidence handling language, creates additional criminal offense provisions tied to mandated reporters and child sexual assault context, modernizes youth employment permitting requirements (including electronic document permission), adds wrong-way driving education and enforcement protocols with infrastructure, reporting, training, and public service announcement requirements, and establishes a statewide Chapter 70 foundation budget review commission to conduct periodic public hearings and make recommendations with implied legislative and regulatory change needs. It also creates or directs multiple commissions and task forces, including a stabilization fund and long-term liability financing task force, an endometriosis task force with a comprehensive report deadline, commissions relating to local aid distribution and transition-age youth with disabilities planning, and a commission to study Massachusetts School Building Authority capacity and equity of grant formula.

For fiscal controls and specific funding transfers, the bill imposes sheriff fiscal oversight for fiscal years 2027–2031 by requiring hiring and spending controls to prevent exceeding appropriations (with possible waivers for public safety needs), prohibiting spending into deficiency without defined supplemental-funding documentation, and establishing a sheriff fiscal oversight council with authority to access records and impose restrictive financial controls, including appointing a receiver. It authorizes certain health-care fund transfers and changes payment mechanisms for Health Safety Net Trust Fund payments, including an initial gross payments process followed by reconciliation and a requirement that certain inspector general audit functions be funded from the Health Safety Net Trust Fund, and it requires an inspector general report to the Senate and House committees on ways and means by March 1, 2027. It allows nursing facility rates beginning October 1, 2026 to be developed using calendar year 2023 costs. It directs specific regional transit authority operating assistance for fiscal year 2027 and requires the Department of Transportation to require ridership, customer service and satisfaction, asset management, and financial-performance data and compile progress toward performance metrics. It mandates fixed-percentage transfers of 100% of specified category 1 licensee revenues among eight specified funds, sets the fiscal year 2027 excess capital gains threshold at $2,250,000,000 and requires quarterly transfers of capital gains above that threshold to specified funds, and directs timing, verification, and reporting rules for transfers affecting the Commonwealth’s Pension Liability Fund and related pension obligations. It requires retention of certain General Fund interest earnings for fiscal year 2027 subject to prior committee notification and certification, requires abandoned property net revenue to remain in the General Fund, requires specific trust fund-to-trust fund transfers in specified amounts and timing, directs a $10,000,000 transfer from the RGGI Auction Trust Fund to the Climatetech Investment Fund in fiscal year 2027, requires the Division of Insurance to promulgate regulations implementing a specified insurance provision by January 1, 2027, and provides that sections 37 through 48 take effect January 1, 2027 while the act generally takes effect on July 1, 2026.

FULL SUMMARY

The bill provides an exception to Minnesota’s hospital construction moratorium (Minn. Stat. § 144.551, subd. 1) by expanding the list of hospital construction or modification projects that may be commenced despite the restriction.

Specifically, the bill adds a new clause to allow (1) a project to add up to 85 licensed beds in an existing safety net, level I trauma center hospital in Ramsey County, designated under Minn. Stat. § 383A.91, subd. 5. It also revises the statutory list of permitted projects by updating the moratorium exception text for multiple existing clauses, and adds detailed conditions for at least the following permitted projects: (2) a project to add 22 licensed beds at a Minnesota freestanding children’s hospital in St. Paul (part of an independent pediatric health system with freestanding inpatient hospitals in Minneapolis and St. Paul) for pediatric inpatient behavioral health services, with an option to proceed before completion of the public interest review if a plan is submitted by a 2022 deadline and timelines in § 144.552 are followed; (3) a project for a 144-bed psychiatric hospital on the former Bethesda Hospital site in Saint Paul, if found in the public interest after the § 144.552 review, requiring the commissioner of health to monitor the hospital (including case mix and payer mix, transfers, and diversions) and requiring the hospital to have an intake and assessment area, accommodate walk-up/ambulance/law-enforcement transfers and transfers from other facilities for acute mental health needs, comply with § 144.551, subd. 1a(b), and annually submit de-identified data in the commissioner-defined format and manner.

The bill further expands permitted bed-relocation authority with specified conditions for (4) relocation of up to 26 licensed long-term acute care hospital beds from an existing long-term care hospital in Hennepin County (with a licensed capacity prior to relocation of 92 beds) into dedicated space on the campus of an existing safety net, level I trauma center hospital in Ramsey County designated under § 383A.91, subd. 5, conditioned on a public interest finding under § 144.552 and continued use of the relocated beds as long-term acute care beds after relocation.

Overall, the operative change is a broadened set of named, geographically and capacity-limited hospital construction/expansion/relocation projects that are exempt from the moratorium, with additional administrative criteria and public interest/review-related conditions attached to particular Ramsey County, Hennepin County relocation, and specific psychiatric/children’s hospital bed-addition projects.

FULL SUMMARY

The bill establishes a Massachusetts study and annual reporting process focused on how emergency medical care is delivered to persons held in custody (including individuals under arrest, en route to incarceration, or incarcerated in correctional agencies such as jails and prisons). It defines relevant terms including “custody,” “correctional agency,” “correctional officer,” “law enforcement officer,” and “emergency medical condition,” where the latter is framed in terms of symptoms whose absence of prompt medical attention could reasonably be expected to cause serious jeopardy, impairment, or dysfunction.

The bill directs the state agency administering the federal Death in Custody Reporting Act (DCRA)—identified as the Research and Policy Analysis Division / Statistical Analysis Center within the Office of Grants and Research of the Executive Office of Public Safety and Security—to submit, not later than 365 days after enactment, information about delivery of emergency medical care to persons in custody to the Massachusetts Attorney General. The reporting is to be developed in consultation with specified law enforcement and corrections stakeholders (including municipal police departments, college/university law enforcement agencies, county correctional facilities, state prisons, state agencies with arrest powers/lock-up facilities, and Emergency Medical Services).

The bill requires the Massachusetts Attorney General, in conjunction with the DCRA state administering agency, to annually acquire, collect, classify, and study delivery of emergency medical care and to report details “in a uniform manner” regarding when and how emergency medical care is summoned and provided. The annual report is required to include: the frequency, nature, and timing of care (including emergency department admissions and hospitalizations, with limited data on causes for admission); EMS activations (including primary impression); and information about medical care provided to a person prior to a death in custody, including other relevant clinical data if available. It also requires a psychiatric-crisis section addressing whether a 3-digit crisis report was made prior to law enforcement contact and whether EMS, hospitalization, or other medical care was provided, including a uniform summary of critical incident responses and medical care where some medical personnel data is not integrated into an electronic medical record.

Overall, the bill requires the data to culminate in a yearly report summarizing the nature/primary impression of medical needs, the prevalence of such emergencies, and whether care was provided in a timely manner.

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 New York’s “Medical Civil Rights Act” by revising Civil Rights Law section 28 to require emergency medical services when a person in direct contact with or in the custody or control of specified law enforcement/correctional personnel has an emergency medical condition or is medically unstable.

It gives such persons an explicit right to emergency medical services (including conditions that are physical, behavioral, or related to substance use or mental health disorders). The bill also imposes a duty on law enforcement/correctional officers (or other covered law enforcement representatives/entities) to provide attention to a covered person’s emergency medical needs and to immediately request emergency medical services, with an exception where the officer makes a reasonable determination that the person is not experiencing an emergency condition/instability and knows the person was seen by a medical professional within the prior 24 hours and released after a determination that the person was not experiencing an emergency condition.

The bill strengthens civil liability: if a person has not received the required emergency medical treatment and suffers serious physical injury or significant exacerbation of an injury/condition, the person has a cause of action against the covered officer/representative/entity. In such actions, the court must award reasonable attorneys’ fees to a successful plaintiff (changing discretionary fee language to a mandatory “shall”).

It further requires that when medical personnel and law enforcement/correctional personnel are simultaneously involved, the law enforcement/correctional personnel must immediately allow medical personnel to commence treatment for a covered person who has communicated that the person is experiencing an emergency medical condition or is medically unstable, or who reasonably appears to be experiencing such conditions. The bill defines key terms—“emergency medical condition,” “medically unstable,” and several covered roles/entities (e.g., “police officer,” “peace officer,” “correctional officer,” “law enforcement representative,” and “medical personnel”)—and provides that the act takes effect immediately.

FULL SUMMARY

The bill creates a new “Compassionate Assistance for Rape Emergencies (CARE) Act” by adding a new section (191.713) that sets the standard of care for hospitals and affiliated urgent care/health facilities providing emergency care to sexual assault victims. It requires oral notice of emergency contraception options, immediate provision of the complete emergency contraception regimen upon request, and sexually transmitted infection screening and treatment. The bill directs the Department of Health and Senior Services to promulgate implementing rules, and includes a nonseverability clause tying rulemaking to Missouri’s rule-approval framework.

The bill replaces existing forensic-examination requirements in section 197.135 and the reimbursement/evidence framework in section 595.220 by repealing sections 197.135 and 595.220 and enacting the three new sections: 191.713 (CARE Act), 197.135 (forensic exam/telehealth and provider requirements), and 595.220 (public safety payment, reimbursement rules, evidence procedures, electronic tracking, and retention). In the enacted 197.135, hospitals must (from the later of Jan. 1, 2023 or six months after establishment of the statewide telehealth network under 192.2520) perform forensic examinations using evidentiary collection kits upon victim/guardian request and consent for victims at least 14; it keeps the minor-handling structure by referencing subsection 2 of 595.220, requires referral of victims under 14 to SAFE CARE providers (and allows referral for ages 14–17), and permits hospitals to still perform exams for under-14 victims by request/consent subject to 595.220 and public safety rules. It also requires provider training at least equivalent to statewide telehealth network training, allows telehealth guidance if the provider is not a SANE or similarly trained clinician, permits limited waivers for technological hardship (up to one year at a time), mandates a waiver if the statewide telehealth network ceases and the hospital cannot comply without it, and exempts “specialty hospitals” (as designated by the department) if they have a transfer policy to an appropriate emergency-department hospital.

In the enacted 595.220, the Department of Public Safety must make payments to appropriate medical providers for reasonable forensic-exam and medical-treatment charges if the victim or guardian consents in writing and if the examination/treatment report is on a form approved by the attorney general with the advice of DPS; DPS must establish maximum reimbursement rates reflecting reasonable costs. The section retains that minors may consent (without disaffirmance by reason of minority and without parent/guardian consent), requires written notice to a parent/guardian that an exam occurred, and sets evidence-collection/chain-of-custody procedures including electronic notification of kits, law-enforcement timelines to take possession and provide to a laboratory, and a 30-year law-enforcement secure period if the offense has not been adjudicated. It also provides for evidentiary kits to be developed and distributed (subject to appropriation) by the Highway Patrol and eligible crime labs, billed so that DPS pays eligible forensic exam and covered medical treatment costs (including emergency contraception) and prohibits charging the victim for the forensic exam; it keeps direction that other medical treatment can be pursued through the crime victims’ compensation fund. The bill specifies DPS establishes rules on reimbursement for children under 14 (including emergency vs. nonemergency definitions/conditions and provider qualifications for nonemergency exams) and that reimbursement is provided regardless of findings.

Finally, 595.220 expands administrative and technical requirements: it requires the attorney general to establish protocols and an electronic platform implementing electronic evidence tracking for kits and components from exam through testing and disposition (with unique alphanumeric identifiers, machine-readable linkages, credentialed access for status checks and updates, and victim/designee tracking via a secured web-based system requiring registration). It mandates participation of all entities with custody or handling responsibilities, requires DPS (with AG advice and assistance from the Department of Health and Senior Services) to maintain a central repository for “unreported” evidentiary collection kits in temperature-controlled storage with retention for five years (and, for minors, five years after the victim turns 18), declares records in the system confidential and not subject to disclosure under Missouri’s public records law, and requires rules to implement the section with nonseverability tied to rule-approval provisions.

FULL SUMMARY

The bill amends and reenacts Va. Code § 32.1-127 to broaden and update the Board’s hospital/nursing home regulation requirements, primarily adding new operational protocols, patient-access rules, testing and safety requirements, and fee/administrative adjustments. It also adds a detailed workplace violence reporting and retention framework for hospitals.

Among the substantive new/updated regulatory mandates, the bill requires: (1) emergency department physician staffing rules with an exception for certain co-located/psychiatric-only arrangements (with specific agreements, clinical oversight, trained staff, and annual reporting to specified legislative and behavioral health entities by November 1); (2) hospital organ-donation protocols including agreements with an organ procurement organization (and tissue/eye bank agreements), family notification procedures, and training requirements for donor-family approach; (3) obstetric and postpartum discharge planning protocols (including protocols for pregnant women in labor and written discharge plans for substance-abusing postpartum women with mandated referrals and CSB discharge plan management); (4) additional hospital inpatient psychiatric refusal/admission communication requirements (direct communication with referring physicians and toxicology review by a clinical toxicologist/poison control specialist when admission suitability is questioned); (5) life-sustaining treatment “medical and ethical appropriateness” decision procedures (second opinion, interdisciplinary review, written explanation, patient/agent participation rights, and written notice for legal remedies); and (6) new or expanded emergency department requirements, including security plans based on risk assessments (with a waiver option) and urine drug screening that must include fentanyl testing.

The bill also adds several compliance and operational requirements affecting access, safety, and continuity of care: hospitals must adopt air medical transportation notice protocols for non-emergent transfers; hospitals must inform patients expected to need outpatient physical therapy to select a provider before discharge; nursing homes/certified nursing facilities must implement substantiated visitation protocols during COVID-19 public health emergencies (including minimum visit frequency, conditions for in-person/virtual visits, technology-failure steps, and website/communication requirements); and hospitals/nursing homes/certified nursing facilities must implement protocols for visits by clergy, allowing appropriate frequency/duration limits and virtual options subject to federal/state guidance. Further, facilities must establish policies governing the permissible access and use of an “intelligent personal assistant” during inpatient services (with HIPAA-aligned health-information protections), hospitals performing planned surgical procedures likely to generate surgical smoke must use smoke evacuation systems, and hospitals must ensure parent/guardian access to minors’ health records via secure websites where not legally barred.

Finally, the bill establishes a hospital workplace violence incident reporting system and related anti-retaliation protections. Hospitals must: (i) document/track/analyze voluntarily reported workplace violence incidents for improvement purposes; (ii) keep records for at least two years including specified minimum data elements (incident timing, description, perpetrator type, location, incident type taxonomy, responses/consequences, and reporter identity); (iii) prohibit discrimination/retaliation for reporting or seeking assistance in incidents; (iv) provide quarterly internal reports to the hospital’s chief medical officer and chief nursing officer; and (v) send annual aggregated reports to the Department, removing personally identifiable information. The bill also adds a fee-setting directive for the issuance/renewal/change of hospital or nursing home licenses to support licensure and inspection costs while limiting how often fees may change (no more frequently than annually) and restricting fee changes to cases where program expenses differ by more than 10% from annual costs.

The bill establishes new Louisiana licensure requirements for hospitals that provide emergency services by creating R.S. 40:2115.34. It changes the criteria for issuing or renewing a hospital license starting January 1, 2027 by requiring specific minimum inpatient and emergency department bed counts and by requiring full compliance with federal EMTALA. It also contains enumerated exemptions that would exempt certain hospitals from these requirements.

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

HB4709 establishes the “Standardized Prior Authorization Act,” which sets statewide requirements governing when and how health insurance issuers (and their contracted private review agents) conduct prior authorization for covered health care services and related utilization review decisions. The Act applies to specified health insurance coverage delivered/issued in Illinois for individuals enrolled under the Illinois Public Aid Code (Article V) or the Children’s Health Insurance Program, and to health insurance coverage issued in Illinois after the effective date. It also requires that issuer prior authorization materials and clinical review criteria be transparent, publicly accessible, and provided in plain language at the point of care.

Operationally, issuers must (1) maintain a complete list of services subject to prior authorization and (2) conspicuously post current prior authorization requirements, written clinical review criteria, and service-specific information on their websites/online portals (with limits on unreasonable access restrictions). Clinical review criteria must align with nationally accepted standards (and are subject to development/update requirements, including annual evaluation). The Act prohibits denying claims for failure to obtain prior authorization when the requirement was not in effect or not publicly disclosed, and restricts issuers from treating certain supplies or routinely used components as “incidental” to deny services. Issuers must also provide advance written notice (generally 60 days) of new or amended prior authorization requirements/restrictions, with limited exceptions (e.g., fraud/abuse, availability/scarcity, FDA-authorized clinical trials, or removal of requirements).

The bill requires standardized electronic prior authorization transaction processes and specific decision timelines: standard prior authorization determinations must be made no later than 5 calendar days after obtaining all necessary information (subject to longer federal minimum timeframes where applicable), and expedited prior authorization for urgent services must be completed within 24 hours after receipt of all needed information (subject to longer federal minimum timeframes). For certain clinical laboratory tests, issuers must accept requests within specified windows tied to specimen collection and timely claims. When issuers issue adverse determinations, they must provide reasons (including evidence-based criteria and missing documentation), appeal rights and instructions, and additional appeal-supporting documentation. Appeals must be reviewed by appropriately qualified physicians under specified credentialing/training/conflict-of-interest rules. Prior authorization approvals generally must be honored for specified durations (generally the lesser of 12 months or the treatment length determined by the provider), with an extension-by-agreement option, and there are protections for continuity of prior authorizations from prior issuers for at least the initial 90 days of new plan coverage. Issuers are also restricted from revoking/further limiting valid prior approvals except under enumerated circumstances (e.g., fraud/abuse, unavailability, safety alerts/public health emergencies, standards changes by recognized accreditation/societies, or required legal changes).

Crucially, the Act establishes enforcement consequences and ongoing oversight: failure to meet deadlines/requirements results in automatic deemed authorization for services subject to review. The Department of Insurance (and private review agents/issuers) face authority to issue cease-and-desist orders and require plans of correction, with administrative fines up to $2,000 per violation for failure to submit or comply with correction plans and/or repeated violations, and complaints may be filed with the Department (with the Act explicitly stating no private right of action). The bill also requires issuer reporting to the Department starting June 1, 2028 and annually thereafter with de-identified aggregated trend data about prior authorization approvals/denials, appeal outcomes, electronic submission rates, denied services, denial reasons, and timing metrics. In addition, the Act grants rulemaking authority to the Department. The bill repeals the Prior Authorization Reform Act and makes conforming changes to the Illinois Insurance Code and Illinois Public Aid Code. Effective January 1, 2027.

FULL SUMMARY

HB4314 changes Section 1 of the Illinois Hospital Emergency Service Act by requiring staffing of hospital emergency departments. Specifically, every hospital licensed by the Illinois Department of Public Health that provides general medical and surgical services must have at least one licensed physician who specializes in emergency medicine staffing the emergency department at all times. The requirement applies to licensed hospitals except for long-term acute care hospitals and rehabilitation hospitals identified in Section 1.3 of the Act.

The bill revises the statutory language within the same Section 1(a) to state the “licensed physician who specializes in emergency medicine” must be staffing the emergency department continuously (“at all times”). It also retains Section 1’s existing framework that emergency services must be provided to any applicant presenting at the hospital or brought by ambulance or specialized EMS vehicle when an injury or acute medical condition is liable to cause death or severe injury or serious illness, and that hospitals must furnish emergency services consistent with EMTALA procedures.

No other operative changes appear in the text beyond this emergency-medicine staffing requirement within Section 1(a). The bill includes statements that the amendments to Section 1 are declarative of existing law and that nothing in the Section alters existing legal statuses and rights.

The act takes effect upon becoming law.

FULL SUMMARY

HB5239 changes Illinois’ Emergency Medical Services (EMS) Systems Act by revising the Freestanding Emergency Center (FEC) licensing provision (210 ILCS 50/32.5). It requires the Department of Public Health to issue an annual FEC license to a facility that meets the enumerated FEC criteria, while adding two specific allowances that affect where FECs may be located and how they may market themselves.

First, for FECs licensed under the “(a-25)” pathway, the bill allows the FEC to be located in a municipality with a population greater than 50,000 inhabitants (previously limited to 50,000 or fewer under the base subsection (a) criteria), and it removes the applicability of Illinois Health Facilities Planning Act requirements that otherwise apply to conversion to an FEC if the Department of Healthcare and Family Services has approved the conversion as a project under that subsection. Second, under the same “(a-25)” licensing pathway, the bill allows an FEC—if operated as provider-based under 42 CFR 413.65—to describe itself or hold itself out to the general public as a hospital emergency department in its advertising and marketing activities.

The bill retains the Department’s general licensing/oversight authorities in subsection (b): annual inspection of initial applicants and licensed FECs, issuance or annual relicensure for those meeting requirements, suspension/revocation/refusal to issue or renew for noncompliance after notice and a hearing opportunity, and the ability to issue an emergency suspension order when continued operation poses an immediate and serious danger to public health, safety, or welfare. It also preserves the Department’s authority to adopt rules necessary to implement the FEC licensing requirements.

FULL SUMMARY

The bill establishes new statutory “medical civil rights” protections in Massachusetts by adding Section 33½ to Chapter 276.

It defines key terms for the new protections, including “emergency medical condition” (a condition—physical, behavioral, related to substance use disorder, or mental—manifesting with sufficiently severe symptoms that a prudent layperson would expect that absence of prompt medical attention would likely result in serious jeopardy, serious impairment to body function, or serious dysfunction of an organ), “medically unstable” (an unstable medical or mental health status reasonably understood by a prudent layperson to lead to an emergency medical condition), and related actor categories such as “law enforcement agency,” “law enforcement officer,” “correctional officer,” “correctional agency,” and “medical personnel.”

The bill creates an operative right for any person experiencing an emergency medical condition or who is medically unstable while in direct audio/visual contact with, or in the custody/control of, a law enforcement or correctional officer, requiring that person to be provided emergency medical services.

It further requires that, except for a specified exception, a law enforcement or correctional officer must immediately request emergency medical services for an individual under the officer’s custody/control or in direct audio/visual contact when the person communicates that they are (A) experiencing an emergency medical condition or (B) medically unstable, or when the officer reasonably observes those same conditions. The bill limits this obligation by exempting an officer who makes a reasonable determination that the person is not experiencing those conditions and who knows the person was evaluated by a medical professional within the prior 24 hours and released after a determination that the person was not experiencing an emergency medical condition or was not medically unstable. In situations where medical personnel and law enforcement/correctional officers are simultaneously involved, it requires the officer to immediately allow medical personnel to commence treatment for the affected person when the relevant condition is communicated or reasonably observed.

FULL SUMMARY

The bill repeals Minnesota’s hospital construction moratorium provisions in Minnesota Statutes, section 144.551, including its related subdivisions defining the moratorium and its exemption framework, while preserving whatever conditions were already imposed when an exemption was previously granted under section 144.551. It also updates related licensing and inspection provisions and makes conforming changes to ensure the moratorium framework is no longer operative.

Specifically, the bill provides that any condition on which a hospital construction moratorium exemption was granted under section 144.551 remains in effect (continuing effect for existing exemptions). It then repeals section 144.551, subdivisions 1, 1a, 2, 3, and 4, and also repeals additional sections connected to the moratorium process: Minnesota Statutes 2024, sections 144.552, 144.553, and 376.08, subdivision 3.

For conforming changes, the bill amends Minnesota Statutes, section 62J.17, subdivision 3 to adjust how the moratorium concept is referenced, clarifying that the section does not supersede or limit the applicability of sections 144.551 or 144A.071, and it includes language excluding from its scope “major spending commitments” made by nursing homes or intermediate care facilities related to long-term care.

The bill also amends Minnesota Statutes, section 144.55: subdivision 4 (routine inspections/presumption) is modified to remove some references that hinge on hospital construction moratorium exceptions (while still directing the commissioner to conduct inspections related to whether a hospital construction/addition/remodeling project complies with standards and to inspect conditions tied to prior exceptions), and subdivision 6 is amended to (1) prevent license renewal for certain boarding care beds (more than four beds in a resident room), and (2) prohibit renewal of hospital beds issued under a hospital construction moratorium exception if the commissioner determines the hospital or hospital corporate system is not satisfying the conditions for the exception.

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 establishes new “medical civil rights” protections in Massachusetts law by adding a new section, Chapter 276, Section 33 ½, defining key terms including “emergency medical condition” (with severity thresholds tied to what a prudent layperson would expect from absence of prompt care), “medically unstable” (defined by an unstable medical or mental health status that a prudent layperson would reasonably understand could lead to an emergency medical condition), and covered personnel (including law enforcement agencies/officers, correctional officers/agencies, and medical personnel).

It grants any person who is experiencing an emergency medical condition or is medically unstable while in direct audio or visual contact with, or in the custody/control of, a law enforcement or correctional officer the right to be provided with emergency medical services.

It further requires that—subject to a limited exception—law enforcement or correctional officers must immediately request emergency medical services when the person has communicated that they are experiencing an emergency medical condition or are medically unstable, or when such conditions have been reasonably observed by the officer.

The bill creates an exception to the immediate-request obligation: an officer is not required to request emergency services if the officer makes a reasonable determination that the person is not experiencing an emergency medical condition or is not medically unstable, and the officer knows the person was seen by a medical professional within the prior 24 hours and released after a determination that the person was not experiencing an emergency medical condition or was not medically unstable. In addition, when medical personnel and officers are simultaneously involved, the officer must immediately allow medical personnel to commence treatment for the affected person upon communication or reasonable observation of an emergency medical condition or medical instability.

FULL SUMMARY

The bill establishes new state requirements for hospital emergency departments regarding pediatric emergency readiness and care standards. A new Utah Code section (53-2d-704) defines key terms, including “emergency department,” “pediatric emergency care coordinator,” and “pediatric readiness assessment” (linked to the National Pediatric Readiness Assessment developed by the National Pediatric Readiness Project).

Emergency departments must: (1) develop and implement evidence-based pediatric patient care policies and procedures addressing pediatric triage protocols, vital-sign measurement/recording, pediatric weight measurement/recording in kilograms, pediatric medication dose calculation, pediatric-specific equipment use, and age-appropriate care protocols; (2) provide annual staff training on these policies/procedures, including hands-on pediatric equipment simulation tied to staff licensure/role; and (3) conduct pediatric emergency drill exercises at least every six months. Each emergency department must designate a pediatric emergency care coordinator who is a physician, physician assistant, or registered/advan ce practice registered nurse meeting specified licensure requirements, with responsibilities including implementing the pediatric policies/procedures, ensuring compliance with pediatric care standards, and coordinating pediatric emergency care training.

Each emergency department must conduct a pediatric readiness assessment according to the National Pediatric Readiness Project’s timelines and submit the assessment results to the Bureau of Emergency Medical Services by December 31 of the assessment year. General acute hospital emergency departments may voluntarily conduct the Project’s “Open Assessment” in years when the required assessment is not conducted. The bureau must collect overall assessment scores, may publish aggregate scores, and must adopt rules establishing minimum pediatric patient care standards for emergency departments, including requirements related to pediatric equipment/supplies access, staff training, quality assurance, and reporting of assessment results.

The bill appropriates $278,000 in fiscal year 2027 (a General Fund reallocation) to the Department of Public Safety for “Emergency Medical Services” / pediatric readiness, with legislative intent that the department provide a direct award grant to the Utah Pediatric Trauma Network for pediatric readiness. The bill takes effect on 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 creates a new public-records exemption in Florida’s public records law (s. 119.071(5)(l)) for specified personal identifying and location information relating to “current emergency department physicians,” defined as physicians licensed under ch. 458 or 459 whose duties are performed in a hospital emergency department licensed under ch. 395. Specifically exempt from disclosure are: (1) the home addresses, personal telephone numbers, and dates of birth of current emergency department physicians; (2) the names, home addresses, personal telephone numbers, dates of birth, and places of employment of the spouses and children under age 26 of such physicians; and (3) the names and locations of schools and day care facilities attended by such under-26 children.

The exemption is expressly retroactive: it applies to the exempt information “held by an agency before, on, or after July 1, 2026.” For agencies that are custodians of the exempt information but are not the employer of the emergency department physician, the custodian must maintain the exempt status only if the individual (physician or qualifying spouse/child) requests maintenance of the exemption and submits a written, notarized request to the custodial agency. The request must state under oath the statutory basis for the request and confirm eligibility; the individual has a duty to withdraw the request if the exemption no longer applies. If the custodian receives a qualifying request, the agency must maintain the exempt status until the qualifying conditions cease to apply to the exempt individual.

The exemption is subject to Florida’s Open Government Sunset Review Act (s. 119.15) and will stand repealed on October 2, 2031 unless reenacted. The bill also includes a legislative “public necessity” statement explaining that release of the specified physician and family information could expose emergency department physicians (and qualifying family members) to physical or emotional harm or stalking, and that the potential harm outweighs any public benefit.

The act takes effect July 1, 2026.

FULL SUMMARY

The bill establishes additional pediatric patient safety requirements for hospitals with emergency departments and creates statewide requirements for pediatric readiness planning, rulemaking, and public reporting of pediatric readiness assessment results.

For hospitals, it requires (starting in new subsections of s. 395.1012) each hospital emergency department to (1) develop and implement evidence-based pediatric emergency care policies and procedures reflecting specified minimum elements (triage; measuring/recording vital signs; weighing/recording weights in kilograms; calculating medication dosages; and use of pediatric instruments), (2) conduct annual training on those policies, including pediatric instrument use using clinical simulation and at least annual emergency drills that simulate emergency situations. It also requires each hospital emergency department to designate a “pediatric emergency care coordinator” who must be a physician or physician assistant licensed under specified chapters, a nurse licensed under specified chapters, or a paramedic licensed under specified chapters, and to ensure adherence to the required pediatric policies and procedures; additionally, it requires the emergency department to conduct the National Pediatric Readiness Assessment under National Pediatric Readiness Project timelines. Separately, hospitals are authorized to conduct the National Pediatric Readiness Project’s “Open Assessment” during years in which the main National Pediatric Readiness Assessment is not conducted.

The bill changes agency rulemaking and comprehensive emergency management plan standards. It requires the Agency for Health Care Administration (AHCA), in consultation with the Florida Emergency Medical Services for Children State Partnership Program, to adopt rules establishing minimum standards for pediatric patient care in hospital emergency departments, including (at minimum) the availability of and immediate access to pediatric-specific equipment and supplies (added as a new rulemaking subsection in s. 395.1055). It also revises s. 395.1055’s comprehensive emergency management plan requirements by specifying that such plans must include additional plan components addressing responding to family inquiries and pediatric and neonatal patient needs, and it retains annual preparation and update and local emergency management agency review/approval.

Finally, the bill amends s. 408.05 to expand AHCA’s health information transparency duties by adding a requirement to collect the overall assessment score of National Pediatric Readiness Assessments from the Florida Emergency Medical Services for Children State Partnership Program by specified deadlines, and to publish overall assessment scores by hospital emergency department by specified future dates. It requires publishing a comparison to the national average score when available, and it limits collection and publication to no more than one overall assessment score per hospital per year, including a comparison to the hospital’s most recently published score. The bill takes effect July 1, 2026.

FULL SUMMARY

The bill establishes an “Emergency Medicine Study Committee” tasked with reviewing Arizona’s emergency medical services system and the state of emergency medicine, focusing on delivery challenges, capacity and rural/urban adequacy, uncompensated care’s effects on financial viability, and factors affecting the stability of emergency medicine providers.

The committee’s membership includes three House members (appointed by the Speaker; one designated chair), three Senate members (appointed by the President), the director of the Arizona Department of Health Services (or designee), two emergency department operators split by county population (under vs. at least 500,000), three emergency medicine physicians split by county population plus a medical director of an emergency medical services agency, one emergency-medicine registered nurse or nurse practitioner, and two pre-arrival EMS providers split by the same county population thresholds; appointment authority is divided between the Speaker and Senate President for the listed public members.

The committee must (1) review EMS system delivery and obstacles to sustainability, (2) analyze emergency medicine capacity including factors affecting adequacy in rural and urban areas, (3) review the financial impact of uncompensated care on the practice of emergency medicine, (4) identify factors impacting provider entity stability, and (5) solicit stakeholder and patient input on both service delivery and emergency medicine financial viability. It may hold public hearings, conduct fact-finding tours, request data from the Department of Health Services, and take testimony; the legislature and the Department of Health Services must provide staffing and support. Members receive no compensation, but are eligible for expense reimbursement under Arizona law.

The bill requires an initial report by December 31, 2026 and annual reports thereafter to the Governor, President of the Senate, and Speaker of the House, with a copy provided to the Secretary of State. The committee is set to be repealed effective after June 30, 2029 (i.e., on or after that date the study committee no longer exists).

FULL SUMMARY

The bill establishes a statewide air medical services program within the Hawaii Department of Health’s Emergency Medical Services and Injury Prevention System Branch to provide governance, coordination, oversight, quality improvement, and disaster readiness for Hawaii’s emergency aeromedical and interfacility air medical transport services.

To staff the program, the bill requires creation of three permanent positions exempt from chapter 76: (1) a physician “state air medical director” to provide statewide clinical and medical oversight; (2) a “state air medical program manager” to administer the program, develop policy, plan the system, coordinate with agencies, and integrate air medical services with emergency medical services, trauma systems, and healthcare facilities; and (3) an “air medical coordinator” to handle operational coordination, data oversight, compliance monitoring, performance improvement, and coordination with licensed air medical providers, county EMS agencies, hospitals, and emergency management partners. It also requires that these positions be permanent and recurring, not contingent on temporary programs, pilot projects, or time-limited funding.

The program is authorized to provide clinical governance; develop and implement statewide policies, procedures, and clinical protocols consistent with nationally recognized standards; coordinate air medical transport across counties to improve timeliness, health equity, and access; oversee licensed providers’ participation in data-based quality improvement; support statewide disaster preparedness/response/recovery for multi-island and mass-casualty incidents; and coordinate with a broad set of EMS and acute care/response partners (including county EMS agencies, hospitals, trauma and stroke centers, acute care facilities, and emergency management agencies). As a condition of licensure, all air medical providers must cooperate with and participate in statewide coordination, data reporting, and quality improvement activities as required by the department; the bill also allows the program to coordinate with the state EMS advisory committee and to establish advisory or quality improvement committees.

The bill requires the Department of Health to establish and assess annual air medical ambulance licensure and accreditation fees, set to be reasonable, non-refundable, and sufficient to cover specified program costs (administration/oversight, licensure/accreditation verification and enforcement, statewide coordination and quality improvement, data collection/reporting, and coordination with emergency management and disaster-preparedness partners). Fees collected must be deposited into the existing Emergency Medical Services Special Fund (HRS §321-234) and used solely to administer and support the statewide air medical services program, staff, and emergency management coordination functions. It also amends HRS §321-234(b) to add that fees remitted under the new air-medical program section are used solely for those purposes, while keeping the annual $3,500,000 county EMS system distribution structure intact and maintaining the prohibition on using the remainder to supplant pre–July 1, 2004 EMS funding. The act takes effect July 1, 3000.

FULL SUMMARY

SB4049 changes the Emergency Medical Services Systems Act (210 ILCS 50/32.5) by adding licensing flexibilities for freestanding emergency centers (FECs) and expanding permissible public-facing marketing language under specified conditions.

The Department of Public Health must issue an annual FEC license to a facility that meets the enumerated FEC requirements in subsection (a), but adds an exception allowing the FEC to be located in a municipality with a population greater than 50,000 (instead of being restricted to 50,000 or fewer for the general rule). Separately, if the facility operates as a provider-based entity under 42 CFR 413.65, it may describe itself or hold itself out to the general public as a “hospital emergency department” in its advertising and marketing activities. A new cross-reference exception is also created by allowing the FEC location/marketing carve-out to apply when the facility otherwise complies with the FEC requirements.

In addition, the bill retains or adjusts multiple existing “notwithstanding any other provision” pathways for issuing annual FEC licenses in specific circumstances (e.g., certain facilities tied to earlier permit/letter-of-intent timelines, counties lacking a licensed general acute care hospital, and facilities converting from a hospital’s inpatient services). For the conversion-based pathway, the bill expressly conditions the municipality-location exception and states that the FEC is not subject to specified Illinois Health Facilities Planning Act requirements applicable to conversion to an FEC if the Department of Healthcare and Family Services has approved the conversion.

The bill does not change the Department’s core enforcement framework: the Department must continue to inspect initial applicants and licensed FECs annually, issue or relicense FECs that satisfy licensure requirements, and may suspend, revoke, refuse to issue, or refuse to renew licenses after notice and an opportunity for a hearing when standards are not met; it also must continue to support emergency suspension orders where continued operation poses an immediate and serious danger, and it authorizes the Department to adopt rules needed to implement the section.

FULL SUMMARY

The bill establishes new requirements for hospital emergency departments to screen and treat individuals who request emergency evaluation, sets duties regarding stabilization and transfer, prohibits delays/denials for specified non-medical reasons, and creates enforcement mechanisms (state civil actions and a private right of action) plus whistleblower/provider protections and obligations for hospitals with specialized facilities to accept transfers when they have capacity.

It also defines key terms (“emergency medical condition,” “hospital,” “emergency medical services,” and “stabilize/stabilizing treatment”) broadly, including pregnancy-related emergencies and medical stabilization standards tied to preventing material deterioration during discharge/transfer. For pregnant patients, it specifies that the definition of emergency medical condition includes a listed set of conditions and circumstances involving inadequate time for safe transfer or threats to patient safety.

The bill further establishes: (1) a duty of care to provide stabilizing treatment when an emergency medical condition is identified; (2) that emergency medical services and stabilizing treatment cannot be delayed or denied for inability to pay, lack of insurance/public benefits, citizenship/immigration status, pregnancy outcome/status, or staff/hospital personal, institutional, or religious beliefs/policies; (3) a limitation that hospitals may not condition medically necessary pregnancy termination on consent of anyone other than the patient or the patient’s legal representative; and (4) strict conditions on when an unstabilized patient may be transferred after appropriate screening, including obligations to minimize risks, ensure receiving capacity and qualified personnel, provide required medical records, use qualified transport and medically appropriate life support, obtain written request after being informed of transfer risks, and require a physician certification weighing expected benefits against increased transfer risks.

For enforcement and remedies, it authorizes the Attorney General and the State Department of Health to investigate and bring civil actions against violating hospitals/providers, with remedies including injunctive relief, civil penalties up to $50,000 per violation, and corrective action orders, license suspension, and Medicaid exclusion for repeat/gross violations. It creates a private cause of action for individuals harmed by violations for compensatory and punitive damages, equitable relief, and reasonable attorney’s fees/costs, and it removes certain liability shields by stating hospitals/providers are not immune based on religious/moral objections and cannot claim immunity under federal conscience protection laws when such objections lead to denial of stabilizing emergency care. It additionally prohibits hospitals from penalizing providers who stabilize patients consistent with medical standards of care and protects hospital employees from retaliation for reporting violations, and requires hospitals with specialized facilities (e.g., trauma, NICU, maternal-fetal medicine) to accept appropriate transfers if capacity exists. The bill takes effect and applies to hospitals/providers operating in Mississippi on and after July 1, 2026.

The bill would add two new hospital requirements to West Virginia’s hospital code: (1) mandatory development of protocols for “trauma informed care” for patients who have experienced miscarriage, abuse, neglect, or other stressful events, including staff training/continuing education and creation of patient resource/assistance materials; and (2) a specific “Butterfly Protocol” for miscarriage patients requiring a discreet visual symbol on a patient’s chart or electronic medical record to alert staff and staff training on the symbol’s meaning and on trauma-informed responses for patients whose records include it.

FULL SUMMARY

The bill establishes a statutory framework for public school employees and agents—including school health assistants—who volunteer to administer specified emergency medications and to assist with diabetes-related tasks, with separate rules from student self-administration. It permits volunteer administration of: epinephrine for anaphylaxis; glucagon in diabetes emergencies; seizure rescue medication for students with epilepsy or other seizure disorders; and asthma rescue inhalers (inhalers for asthma or other chronic lung diseases). It also permits insulin administration/assistance via the student’s insulin delivery system and blood glucose monitoring/assistance.

For emergency medication or diabetes assistance tied to a specific student, the student’s parent/guardian must provide (1) a written request and authorization, (2) written medical orders from an authorized prescriber (physician, APRN, PA, or other practitioner with prescriptive authority), and (3) the prescribed medication supply and any necessary devices/equipment. The permission is effective for the school year and must be renewed each subsequent school year upon fulfilling section requirements. The bill allows secure but accessible storage of student medication/supplies by the public school. Volunteers must receive instruction on proper administration from a licensed physician/PA/RN/APRN or other qualified licensed healthcare professional; for insulin/blood glucose monitoring instruction, the bill also specifies a certified diabetes educator as a qualified professional.

The bill expands and updates liability protections for public schools, personnel/agents, and medical providers acting in good faith in accordance with the section. It requires the department/public school to inform the parent/guardian in writing that compliance may not incur liability from injuries arising from compliance, requires a signed parent/guardian acknowledgment including indemnification/hold harmless, and grants immunity from civil or criminal liability except for gross negligence, willful and wanton misconduct, or intentional misconduct. It also defines key terms used in the emergency-medication framework, including “bronchodilators,” “epinephrine,” “glucagon,” “inhaler,” and “seizure rescue medication,” in a way that expressly covers multiple FDA-approved delivery forms/devices.

Separately, the bill amends the student self-administration statute (HRS §302A-1164) to revise the scope and terminology of what students may self-administer and what is permitted for school volunteering. It updates the “inhaler” concept and clarifies the permitted medication categories (asthma, anaphylaxis, diabetes, and other potentially life-threatening illnesses) and adjusts the volunteering-related medication categories to align with the broader emergency-medication and diabetes-assistance framework. The bill also updates the definition and permissions related to student carrying of self-administered medication and devices, and it amends the immunity clause to maintain the gross-negligence/willful-and-wanton/intentional-misconduct exception. The bill’s effective date is upon approval.

The bill establishes a new statutory requirement for Missouri hospitals that operate emergency departments. It requires each such hospital to keep at least one physician physically on site and on duty who is responsible for the emergency department at all times the emergency department is open.

The operative change is the addition of a new section in Chapter 197 of the Revised Statutes of Missouri, designated as section 197.062, containing the staffing-at-all-times requirement described above. No other provisions, definitions, enforcement mechanisms, penalties, or effective date are included in the provided text.

FULL SUMMARY

The bill establishes statewide, data-driven continuous quality improvement for time-sensitive emergencies (including cardiac, stroke, and trauma). It creates a “single statewide time-sensitive emergencies data repository” to collect and analyze incidence, severity, and causes of these events, defines required datasets and reporting, and requires the Department of Health (the department) to perform oversight, validation, technical assistance, and performance reporting.

It amends RCW 70.168.090 and RCW 70.168.150. For RCW 70.168.090, the bill shifts from a trauma-only registry to (i) maintaining the trauma registry until the time-sensitive emergencies data repository is established by January 1, 2031, and then (ii) establishing the time-sensitive emergencies repository by January 1, 2031. It also expands required hospital/provider submissions to quarterly reporting beginning January 1, 2031 for trauma, cardiac events, and stroke events; requires a repository data validation and continuous data quality improvement process; adds department obligations for system performance oversight, quarterly system performance/quality reporting, feedback to ambulance/aid services and hospitals, and using data to develop standards and interventions.

For RCW 70.168.150, the bill updates the cardiac and stroke system participation framework by aligning hospital data submission with the new repository starting January 1, 2031 (while retaining requirements for participating hospitals to engage in quality improvement and participate in national/state/local data collection systems, including consensus stroke measures). It also adds department funding-supported and public education provisions related to heart attack/stroke symptoms and 911 use, plus clarifies program confidentiality and—by amended language—includes authority to contract with a single entity through competitive procurement to develop and administer the statewide repository.

Overall, the core new establishment is the statewide time-sensitive emergencies data repository (with datasets for trauma, cardiac events, and stroke events; quarterly submissions by specified providers; data validation and continuous quality improvement; quarterly aggregate reporting and public posting of data), alongside expanded department oversight duties and updated cardiac/stroke program data-reporting requirements beginning in 2031.

FULL SUMMARY

The bill requires the State Board of Medical Examiners to ensure that each physician’s biennial continuing medical education (CME) credits for renewal include one credit earned through educational programs or topics focused on communication with and treatment of persons who are deaf or hard of hearing. The CME training content must meet the requirements of the specific training program standard established in existing law (referenced as subsection b. of section 1 of P.L.2021, c.79), and the new CME requirement is governed by the existing CME enforcement/administrative provisions referenced in section 10 of P.L.2001, c.307.

The Division of Deaf and Hard of Hearing in the Department of Human Services must create a dedicated training and outreach unit. That unit is tasked with developing and administering a training program on communication with and treatment of persons who are deaf or hard of hearing for individuals who work in the emergency department of a general hospital licensed under P.L.1971, c.136.

In consultation with the Division, each emergency department of a licensed general hospital must develop and implement a training protocol covering proper communication and treatment for emergency-department employees who may interact with deaf or hard-of-hearing individuals as part of their jobs.

The act takes effect 90 days after enactment.

FULL SUMMARY

The bill establishes statutory requirements governing when licensed general hospitals may advertise or hold themselves out as providing level-one or level-two pediatric emergency department services. It also requires the Department of Health (DOH) to compile pediatric emergency department registry data submitted by hospitals and include hospital-specific pediatric emergency care data in the New Jersey Hospital Performance Report.

For level-one pediatric emergency departments, a general hospital may not market the service unless it maintains (1) a separate, designated pediatric emergency department exclusively for pediatric patients; (2) a director who is a board-certified pediatric emergency medicine physician who cannot direct any other pediatric emergency department; (3) a nurse with day-to-day managerial responsibility who is a certified pediatric emergency nurse and cannot have a managerial role at any other pediatric emergency department; (4) 24-hour staffing by specified qualified physicians (including board-certified pediatric emergency physicians, or other enumerated alternatives); (5) staff in specified pediatric subspecialties (e.g., pediatric anesthesiology, cardiology, hematology/oncology, infectious diseases, nephrology, neurology, orthopedics, pulmonology, radiology, and surgery); (6) formal consultative relationships with additional enumerated physician subspecialists available for consultation within one hour; and (7) separate pediatric inpatient and pediatric intensive care units in the hospital.

For level-two pediatric emergency departments, a hospital may not advertise or otherwise hold itself out as providing the service unless it meets parallel requirements on pediatric leadership and nursing (including the same director and nurse-management restrictions), maintains designated pediatric patient space, and has (either) separate pediatric inpatient/pediatric intensive care capability or a formal transfer agreement with a level-one pediatric emergency provider. Level-two also requires formal consultative relationships with a specified set of pediatric subspecialists available for one-hour consultations, and it defines “pediatric” as patients from the 29th day after birth through (but not including) the 18th birthday.

The bill requires DOH to compile annually the pediatric emergency medicine registry data submitted by each general hospital (under existing N.J.A.C. requirements) and include hospital-specific data elements—selected by DOH as most relevant—in the annual New Jersey Hospital Performance Report. The Commissioner of Health must adopt rules under the Administrative Procedure Act as necessary to implement the act, and the act takes effect on the first day of the sixth month after enactment, with the commissioner allowed to take anticipatory administrative action before then.

The document outlines amendments to Washington state laws concerning the dispensing and delivery of medications from hospitals and healthcare entities. A significant change allows hospitals to permit practitioners to prescribe limited amounts of prepackaged emergency medications to patients being discharged from emergency departments when community or outpatient pharmacy services are unavailable. This provision is particularly relevant for medications related to opioid overdose reversal, treatment for opioid use disorder, and human immunodeficiency virus postexposure prophylaxis.

The amendments establish specific conditions under which medications can be dispensed, including the lack of access to pharmacy services within a 15-mile radius and patients' inability to reach local pharmacies. Hospitals are required to develop policies regarding the types of emergency medications that can be prepackaged and distributed, ensuring that these medications are prepared under the supervision of licensed pharmacists.

Training for practitioners and nurses involved in dispensing these medications is mandated, and a valid prescription must be maintained in patient records prior to distribution. Additionally, a maximum of a 48-hour supply of emergency medication can be dispensed, with certain exceptions.

The amendments reinforce the requirement for healthcare entities to be licensed to purchase, administer, dispense, and deliver legend drugs and controlled substances, with oversight by pharmacists. These changes are expected to impact the healthcare industry, particularly hospitals and pharmacies, as well as the pharmaceutical sector involved in the production and distribution of emergency medications.

While specific monetary impacts are not detailed, the changes may lead to increased operational costs for hospitals related to policy development, training, and compliance with new regulations. Pharmacies may also experience financial implications due to alterations in medication dispensing practices.

FULL SUMMARY

The bill creates new statutory definitions and operational/quality requirements for “hospital-sponsored off campus emergency departments” within New York’s Public Health Law.

First, it amends the definition of “Hospital” in Public Health Law § 2801(1) to expressly include “hospital-sponsored off campus emergency department” as one of the facility types encompassed within “hospital.” Second, it adds a new subdivision to define “hospital-sponsored off campus emergency department” as an emergency department owned by a general hospital and geographically removed from the hospital’s inpatient campus.

Third, it adds a new Public Health Law § 2802-c establishing requirements for these off-campus departments. The department must generally operate 24 hours per day, 7 days per week, but the bill permits part-time operation of at least 12 hours per day only if the department applies for and receives approval under an existing approval pathway in § 2802, including approval by the Public Health and Health Planning Council. Approval is limited to cases where local special circumstances necessitate part-time operation and must consider quality and accessibility of emergency care and the public interest. The bill also requires off-campus departments to meet the same standards and requirements as general-hospital-based emergency departments, including minimum training of providers, staffing, and capacity to stabilize and treat patients regardless of ability to pay in accordance with federal law and rules. It further requires the off-campus department to have capacity to receive ground ambulance patients and to establish transfer protocols with local EMS providers and general-hospital-based emergency departments to ensure timely transfer of patients needing a higher level of care.

The bill takes effect immediately.

FULL SUMMARY

The bill requires emergency room and hospital practitioners to notify the patient’s prescriber when the patient is being treated for a controlled substance overdose.

It amends Public Health Law § 3371 to add an explicit permitted disclosure to a practitioner: hospital or emergency room practitioners may notify the patient’s prescriber that the patient is under treatment for a controlled substance overdose. The bill also adjusts related confidentiality/record-access cross-references within § 3371’s practitioner disclosure provisions.

It amends Public Health Law § 3343-a’s directive that emergency room or hospital practitioners consult the prescription monitoring program registry when treating a patient for a controlled substance overdose and notify the patient’s prescriber of such overdose. The bill clarifies that, in addition to emergency room/hospital practitioners, notification is tied to when a practitioner is treating a patient for a controlled substance overdose.

The bill takes effect immediately; however, the amendments to paragraph (a) of subdivision 2 of § 3371 are subject to expiration and reversion under the limited reversion provision in Chapter 90 of the Laws of 2014, with the related later changes taking effect when § 3 takes effect.