H 583 — An act relating to clinical decision making

chapter 28, or as a physician assistant pursuant to 26 V.S.A.

chapter 31 who is authorized to diagnose and treat in the applicable clinical setting.

(11) “Management services organization” means any organization or entity that contracts with a health care provider or provider organization to perform management or administrative services relating to, supporting, or facilitating the provision of health care services.

(12)(A) “Material change transaction” means any of the following, occurring during a single transaction or in a series of related transactions involving a health care entity within the State that has total assets, annual revenues, or anticipated annual revenues for new entities, of at least $1,000,000.00, including both in-state and out-of-state assets and revenues:

(i) a corporate merger including one or more health care entities;

(ii) an acquisition of one or more health care entities, including insolvent health care entities;

BILL AS PASSED BY THE HOUSE H.583 Page 6 of 39 (iii) any affiliation, arrangement, or contract that results in a change of control for a health care entity;

(iv) the formation of a partnership, joint venture, accountable care organization, parent organization, or management services organization for the purpose of administering contracts with health insurers, third-party administrators, pharmacy benefit managers, or health care providers;

(v) a sale, purchase, lease, affiliation, or transfer of control of a board of directors or governing body of a health care entity;

(vi) a real estate sale or lease agreement involving a material amount of assets of a health care entity;

or (vii) the closure of a health care facility, or the closure, discontinuance, or significant reduction of any essential health service provided by a health care entity that is either a provider organization or health care facility or any new contracts or clinical or contractual affiliations that will eliminate or significantly reduce essential services.

(B) “Material change transaction” does not include any of the following:

(i) a clinical affiliation of health care entities formed solely for the purpose of collaborating on clinical trials;

(ii) graduate medical education programs;

BILL AS PASSED BY THE HOUSE H.583 Page 7 of 39 (iii) the mere offer of employment to, or hiring of, an individual health care provider;

or (iv) situations in which the health care entity directly, or indirectly through one or more intermediaries, already controls, is controlled by, or is under common control with, all other parties to the transaction, such as a corporate restructuring.

(13) “Medical practice” means a corporate entity or partnership organized for the purpose of practicing medicine and permitted to practice medicine in this State, including partnerships, professional corporations, limited liability companies, and limited liability partnerships.

(14) “Noncompetition agreement” means a written agreement between a licensee and another person in which the licensee agrees that the licensee, either alone or as an employee, associate, or affiliate of a third person, will not compete with the other person in providing products, processes, or services that are similar to the other person’s products, processes, or services for a period of time or within a specified geographic area after termination of employment or termination of a contract under which the licensee supplied goods to or performed services for the other person.

(15) “Nondisclosure agreement” means a written agreement under the terms of which a licensee must refrain from disclosing partially, fully, directly, or indirectly to any person, other than another party to the written agreement BILL AS PASSED BY THE HOUSE H.583 Page 8 of 39 or to a person specified in the agreement as a third-party beneficiary of the agreement:

(A) a policy or practice that a party to the agreement required the licensee to use in patient care, other than individually identifiable health information that the licensee must not disclose under the Health Insurance Portability and Accountability Act of 1996, Pub.

L.

No.

104-191;

(B) a policy, practice, or other information about or associated with the licensee’s employment, conditions of employment, or rate or amount of pay or other compensation;

or (C) any other information the licensee possesses or to which the licensee has access by reason of the licensee’s employment by, or provision of services for or on behalf of, a party to the agreement, other than information that is subject to protection under applicable law as a trade secret of, or otherwise proprietary to, another party to the agreement or to a person specified in the agreement as a third-party beneficiary of the agreement.

(16) “Nondisparagement agreement” means a written agreement under which a licensee must refrain from making to a third party a statement about another party to the agreement or about another person specified in the agreement as a third-party beneficiary of the agreement, the effect of which causes or threatens to cause harm to the other party’s or person’s reputation, business relations, or other economic interests.

BILL AS PASSED BY THE HOUSE H.583 Page 9 of 39 (17) “Ownership or investment interest” means any of the following:

(A) direct or indirect possession of equity in the capital, stock, or profits totaling more than five percent of an entity;

(B) interest held by an investor or group of investors who engage in the raising or returning of capital and who invest, develop, or dispose of specified assets;

or (C) interest held by a pool of funds by investors, including a pool of funds managed or controlled by private limited partnerships, if those investors or the management of that pool or private limited partnership employs investment strategies of any kind to earn a return on that pool of funds.

(18) “Private equity fund” means a publicly traded or nonpublicly traded company that collects capital investments from individuals or entities and purchases a direct or indirect ownership share or controlling interest of a health care entity.

(19) “Provider organization” means any corporation, partnership, business trust, association, or organized group of persons that is in the business of health care delivery or management, whether incorporated or not, that represents one or more health care providers in contracting with health insurers for payment for health care services.

The term includes physician organizations, physician-hospital organizations, independent practice associations, provider networks, accountable care organizations, management BILL AS PASSED BY THE HOUSE H.583 Page 10 of 39 services organizations, and any other organization that contracts with health insurers for payment for health care services.

(20) “Significant equity investor” means:

(A) any private equity fund with a direct or indirect ownership or investment interest in a health care facility;

(B) an investor, group of investors, or other entity with a direct or indirect possession of equity in the capital, stock, or profits totaling more than 10 percent of a provider or provider organization;

or (C) any private equity fund, investor, group of investors, or other entity with a direct or indirect controlling interest in a health care entity or that operates the business or substantially all the property of a health care entity under a lease, management, or operating agreement.

Subchapter 2.

Prohibited Transactions § 9525.

PROHIBITED TRANSACTIONS (a) The following transactions are prohibited:

(1) a transaction that would give a party ownership of the core business operations of an essential community provider, as defined in 45 C.F.R.

§ 156.235(c);

(2) a transaction that involves financing the acquisition of a health care entity through the use of debt that will become an obligation of one or more of the health care entities that are party to the transaction;

BILL AS PASSED BY THE HOUSE H.583 Page 11 of 39 (3) a transaction that involves issuing dividends or other shareholder returns financed by debt that will become an obligation of one or more of the health care entities that are party to the transaction;

(4) a transaction that involves entering into any contract or other service or purchasing arrangement with an affiliated legal entity, except for a contract or arrangement to provide services or products, or both, that are necessary to accomplish the legitimate health care purposes of the relevant health care entity and the contract or arrangement provides for compensation or reimbursement that is consistent with the fair market value of the services rendered or products delivered;

or (5) a transaction that would result in one or more health care entities that does not accept, or that places limitations on, patients covered by Medicaid, original Medicare, or Medicare Advantage.

(b) Nothing in this section shall be construed to limit or alter any existing authority of the Attorney General or any other State agency to enforce any other law, including State or federal antitrust law, or to review transactions involving nonprofit entities.

Subchapter 3.

Prohibition on Corporate Practice of Medicine § 9531.

CORPORATE PRACTICE OF MEDICINE PROHIBITED (a) It is unlawful for an individual, corporation, partnership, or any other entity without a license under 26 V.S.A.

chapter 23 or 33 to own a BILL AS PASSED BY THE HOUSE H.583 Page 12 of 39 medical practice, employ licensees, or otherwise engage in the practice of medicine.

(b) Notwithstanding subsection (a) of this section, an individual, corporation, partnership, or any other entity without a license under 26 V.S.A.

chapter 23 or 33 that is permitted to employ licensees under section 9532 of this chapter shall not indirectly or directly interfere with, control, or otherwise direct the professional judgment or clinical decisions of a licensee.

§ 9532.

CORPORATE ENTITIES PERMITTED TO EMPLOY PHYSICIANS (a) A medical practice organized for the purpose of practicing medicine may employ physicians and engage in the practice of medicine only if all of the following conditions are met:

(1) Licensees who are licensed in this State to practice medicine must hold the majority of each class of shares that are entitled to vote.

(2) Licensees who are licensed in this State to practice medicine must comprise a majority of the directors.

(3) All officers except the secretary and treasurer, if any, must be licensees who are licensed in this State to practice medicine.

The same individual may hold any two or more offices.

BILL AS PASSED BY THE HOUSE H.583 Page 13 of 39 (b) Notwithstanding any provision of subsection (a) of this section to the contrary, the following entities may employ physicians and engage in the practice of medicine:

(1) federally qualified health centers;

(2) rural health clinics;

(3) free and referral clinics;

(4) nonprofit hospitals;

(5) hospitals and other health care facilities owned or operated, or both, by the State;

(6) ambulatory surgical centers;

and (7) school-based health clinics, including student health centers at postsecondary schools.

§ 9533.

REGULATION OF CONTRACTS BETWEEN MEDICAL PRACTICES AND MANAGEMENT SERVICES ORGANIZATIONS (a) Prohibition on straw ownership.

(1) Each licensee owner of a medical practice shall exhibit meaningful ownership of the medical practice.

(2) Meaningful ownership means that each licensee owner is duly licensed and present in this State and is substantially engaged in delivering medical care or managing the medical practice, or both.

BILL AS PASSED BY THE HOUSE H.583 Page 14 of 39 (b) Prohibition on dual ownership or interests.

(1) Except as provided in subdivision (2) of this subsection, a shareholder, director, or officer of a medical practice shall not do any of the following:

(A) own or control shares in, serve as a director or officer of, be an employee of or an independent contractor with, or otherwise participate in managing both the medical practice and a management services organization with which the medical practice has a contract;

or (B) receive substantial compensation or remuneration from a management services organization in return for ownership or management of the medical practice.

(2) Subdivision (1) of this subsection shall not apply to the shareholders, directors, or officers of a medical practice if the medical practice owns a majority of the interest in the management services organization or separate legal entity.

(c) Prohibition on stock transfer restriction agreements.

(1) A medical practice shall not transfer or relinquish control over the sale, the restriction of the sale, or the encumbrance of the sale of the medical practice’s shares or assets.

(2) A medical practice shall not transfer or relinquish control over the issuing of shares of stock in the medical practice, in a subsidiary of the BILL AS PASSED BY THE HOUSE H.583 Page 15 of 39 medical practice or an entity affiliated with the medical practice, or the paying of dividends.

(d) Prohibition on restrictive covenants.

(1) Noncompetition agreements.

(A) Except as provided in subdivision (B) of this subdivision (d)(1), a noncompetition agreement between a licensee and another person is void and unenforceable.

(B) Notwithstanding subdivision (A) of this subdivision (d)(1), a noncompetition agreement between a licensee and another person is valid and enforceable if the licensee is a shareholder or member of the other person or otherwise owns or controls an ownership or membership interest that is equivalent to 25 percent or more of the entire ownership or membership interest that exists in the other person.

(2) Nondisclosure and nondisparagement agreements.

(A) Except as provided in subdivision (B) of this subdivision (d)(2), a nondisclosure agreement or nondisparagement agreement between a licensee and a management services organization is void and unenforceable.

(B) Subdivision (A) of this subdivision (d)(2) shall not be deemed to limit or otherwise affect any cause of action that:

(i) a party to, or third-party beneficiary of, the agreement may have with respect to a statement of a licensee that constitutes libel, slander, a BILL AS PASSED BY THE HOUSE H.583 Page 16 of 39 tortious interference with contractual relations, or another tort for which the party has a cause of action against the licensee;

and (ii) does not depend upon or derive from a breach or violation of an agreement described in subdivision (1) of this subsection (d).

(e) Limitations on advertising.

It is unlawful for a management services organization or other legal entity that is not the medical practice to advertise the medical practice’s services under the name of the entity that is not the medical practice.

(f) Prohibition on relinquishing control of medical practice.

(1) A medical practice shall not, by means of a contract or other agreement or arrangement, by providing in the medical practice’s articles of incorporation or bylaws, by forming a subsidiary or affiliated entity, or by other means, relinquish control over or otherwise transfer de facto control over any of the medical practice’s administrative, business, or clinical operations that may affect clinical decision making or the nature or quality of medical care that the medical practice delivers.

(2) Conduct prohibited under subdivision (1) of this subsection includes relinquishing ultimate decision-making authority over:

(A) hiring or termination, setting work schedules and compensation, or otherwise specifying terms of employment of employees who are licensed BILL AS PASSED BY THE HOUSE H.583 Page 17 of 39 to practice medicine in this State or who are licensed in this State as a physician assistant or advanced practice registered nurse;

(B) the disbursement of revenue generated from physician fees and other revenue generated by physician services;

(C) collaboration and negotiation with hospitals and other health care facilities in which the licensees of the medical practice may deliver clinical care, including controlling licensee schedules as a means of discipline;

(D) setting staffing levels, or specifying the period of time that a licensee may spend with a patient, for any location that serves patients;

(E) making diagnostic coding decisions;

(F) setting clinical standards or policies;

(G) setting policies for patient, client, or customer billing and collection;

(H) setting the prices, rates, or amounts the medical practice charges for a licensee’s services;

or (I) negotiating, executing, performing, enforcing, or terminating contracts with third-party payers or persons who are not employees of the medical practice.

(3) The conduct described in subdivision (2) of this subsection does not prohibit:

BILL AS PASSED BY THE HOUSE H.583 Page 18 of 39 (A) collection of quality metrics as required by law or in accordance with an agreement to which the medical practice is a party;

or (B) setting criteria for reimbursement under a contract between the medical practice and an insurer or a payer or entity that otherwise reimburses the medical practice for providing medical care.

(4) A medical practice may relinquish or transfer control over the medical practice’s administrative, business, or clinical operations that will not affect clinical decision making or the nature or quality of medical care that the medical practice delivers, provided that the medical practice executes a shareholder agreement exclusively between or among and for the benefit of a majority of shareholders who are physicians licensed in this State to practice medicine and the shareholder agreement.

§ 9534.

PROTECTIONS FOR EMPLOYED LICENSEES (a) Application.

The provisions set forth in this section apply to licensees who are employed by, or who provide health care services under contract with, an unlicensed person, corporation, or other entity under section 9532 of this chapter.

(b) Prohibition on restrictive covenants.

(1) Noncompetition agreements.

A noncompetition agreement between a licensee and an employer or other entity is void and unenforceable.

(2) Nondisclosure and nondisparagement agreements.

BILL AS PASSED BY THE HOUSE H.583 Page 19 of 39 (A) Except as provided in subdivision (B) of this subdivision (b)(2), a nondisclosure agreement or nondisparagement agreement between a licensee and an employer or other entity is void and unenforceable.

(B) Subdivision (A) of this subdivision (b)(2) shall not be deemed to limit or otherwise affect any cause of action that:

(i) a party to, or third-party beneficiary of, the agreement may have with respect to a statement of a licensee that constitutes libel, slander, a tortious interference with contractual relations, or another tort for which the party has a cause of action against the licensee;

and (ii) does not depend upon or derive from a breach or violation of an agreement described in subdivision (1) of this subsection (b).

(c) Prohibition on directing licensee’s professional judgment or clinical decisions.

Conduct prohibited under subsection 9531(b) of this chapter includes controlling, either directly or indirectly, through discipline, punishment, threats, adverse employment actions, coercion, retaliation, excessive pressure, or otherwise, any one or more of the following:

(1) the period of time a licensee may spend with a patient, including the time permitted for a licensee to triage patients in the emergency department or evaluate admitted patients;

(2) the period of time within which a licensee must discharge a patient;

BILL AS PASSED BY THE HOUSE H.583 Page 20 of 39 (3) the clinical status of a patient, including whether the patient should be admitted to inpatient status, whether the patient should be kept in observation status, whether the patient should receive palliative care, and whether and where the patient should be referred upon discharge, such as a skilled nursing facility;

(4) the diagnoses, diagnostic terminology, or codes that are entered into the medical record by the licensee;

(5) the range of clinical orders available to licensees, including by configuring the medical record to prohibit or significantly limit the options available to the licensee;

or (6) any other action specified by rule to constitute impermissible interference or control over the clinical judgment and decision making of a licensee.

Subchapter 4.

Transparency in Ownership and Control of Health Care Entities § 9541.

REPORTING OF OWNERSHIP AND CONTROL OF HEALTH CARE ENTITIES (a) Except as otherwise provided in subsection (b) of this section, each health care entity shall report to the Attorney General and the Green Mountain Care Board at least once every two years and upon the consummation of a material change transaction involving the entity, in a form and manner required by the Green Mountain Care Board, the following information:

BILL AS PASSED BY THE HOUSE H.583 Page 21 of 39 (1) the health care entity’s legal name;

(2) the health care entity’s business address;

(3) the locations of the health care entity’s operations;

(4) the health care entity’s business identification numbers, as applicable, including:

(A) taxpayer identification number (TIN);

(B) national provider identifier (NPI);

(C) employer identification number (EIN);

(D) Centers for Medicare and Medicaid Services certification number (CCN);

(E) National Association of Insurance Commissioners (NAIC) identification number;

(F) a personal identification number associated with a license issued by the Department of Financial Regulation;

and (G) a pharmacy benefit manager identification number associated with a licensed issued to a pharmacy benefit manager in this State;

(5) the name and contact information of a representative of the health care entity;

(6) the name, business address, and business identification numbers listed in subdivision (4) of this subsection for each person who, with respect to the relevant health care entity:

BILL AS PASSED BY THE HOUSE H.583 Page 22 of 39 (A) has an ownership or investment interest;

(B) has a controlling interest;

(C) is a management services organization;

or (D) is a significant equity investor;

(7) a current organizational chart showing the business structure of the health care entity, including:

(A) any entity listed in subdivision (6) of this subsection (a);

(B) affiliates, including entities that control or are under common control as the health care entity;

and (C) subsidiaries;

(8) for a health care entity that is a provider organization or a health care facility:

(A) the affiliated health care providers identified by name, license type, specialty, NPI, and other applicable identification number listed in subdivision (4) of this subsection (a);

the address of each health care provider’s principal practice location;

and whether the health care provider is employed or contracted by the entity;

and (B) the name and address of affiliated health care facilities by license number, license type, and capacity;

(9) the names;

NPI, if applicable;

and compensation of:

BILL AS PASSED BY THE HOUSE H.583 Page 23 of 39 (A) the members of the health care entity’s governing board, board of directors, or similar governance body;

(B) any entity that is owned or controlled by, affiliated with, or under common control as the health care entity;

and (C) any entity listed in subdivision (6) of this subsection (a);

and (10) comprehensive financial reports of the health care entity and any ownership and control entities, including audited financial statements, cost reports, annual costs, annual receipts, realized capital gains and losses, accumulated surplus, and accumulated reserves.

(b) The following health care entities are exempt from the reporting requirements set forth in subsection (a) of this section:

(1) a health care entity that is an independent provider organization, without any ownership or control entities, consisting of two or fewer physicians;

provided, however, that if such health care entity experiences a material change transaction under subchapter 2 of this chapter, the health care entity is subject to reporting under subsection (a) of this section upon the consummation of the transaction;

and (2) a health care provider or provider organization that is owned or controlled by another health care entity, if the health care provider organization is shown in the organizational chart submitted under subdivision (a)(7) of this section and the controlling health care entity reports all the BILL AS PASSED BY THE HOUSE H.583 Page 24 of 39 information required under subsection (a) of this section on behalf of the controlled or owned entity;

provided, however, that health care facilities are not subject to this exemption.  § 9542.

SHARING OF OWNERSHIP INFORMATION TO IMPROVE TRANSPARENCY (a) Information provided under this section shall be public information and shall not be considered confidential, proprietary, or a trade secret;

provided, however, that any individual health care provider’s taxpayer ID that is also the individual’s Social Security number shall be exempt from public inspection and copying under the Public Records Act and shall be kept confidential.  (b) On or before February 1, 2027, and every two years thereafter, the Green Mountain Care Board shall post on its website a report with respect to the previous two-year period, including:

(1) the number of health care entities reporting for such year, disaggregated by the business structure of each specified entity;

(2) the names, addresses, business structure of any entities with an ownership or controlling interest in each health care entity;

(3) any change in ownership or control for each health care entity;

(4) any change in the tax identification number of a health care entity;

(5) as applicable, the name, address, tax identification number, and business structure of other affiliates under common control, subsidiaries, and BILL AS PASSED BY THE HOUSE H.583 Page 25 of 39 management services entities as the health care entity, including the business type and the tax identification number of each;

and (6) an analysis of trends in horizontal and vertical consolidation, disaggregated by business structure and provider type.

(c) The Green Mountain Care Board may share information reported under this subchapter with the Attorney General, the Secretary of State, other State agencies, and other State officials to reduce or avoid duplication in reporting requirements or to facilitate oversight or enforcement pursuant to the Vermont law, or both, and any tax identification numbers that are individual Social Security numbers may be shared with the Attorney General, other State agencies, and other State officials who agree to maintain the confidentiality of such information.

The Board may, in consultation with the relevant State agencies, merge similar reporting requirements where appropriate.

Subchapter 5.

Enforcement of Chapter § 9547.

ENFORCEMENT OF CHAPTER (a) A violation of this chapter shall be deemed a violation of the Consumer Protection Act, 9 V.S.A.

chapter 63.

The Attorney General shall have the same authority as provided in 9 V.S.A.

chapter 63, subchapter 1.

(b) Notwithstanding any provision of 9 V.S.A.

§ 2458 to the contrary:

(1) for a violation of section 9531, 9532, or 9534 of this chapter, the civil penalty imposed shall be not more than $10,000.00 per violation;

and BILL AS PASSED BY THE HOUSE H.583 Page 26 of 39 (2) for a violation of section 9525 or 9533 of this chapter, the civil penalty imposed shall be not less than $100,000.00 per violation.

(c) Penalties collected pursuant to this section shall be deposited in the Transaction Oversight and Clinical Decision-Making Fund established pursuant to section 9548 of this chapter.

§ 9548.

TRANSACTION OVERSIGHT AND CLINICAL DECISION- MAKING FUND There is established the Transaction Oversight and Clinical Decision- Making Fund as a special fund pursuant to 32 V.S.A.

chapter 7, subchapter 5, for the purpose of providing a financial means for the Office of the Attorney General to administer its duties under this chapter, including hiring outside experts and investigators as needed.

The Fund shall consist of the penalty sums collected pursuant to section 9547 of this chapter.

Sec.

2.

EFFECTIVE DATE This act shall take effect on July 1, 2026.

Sec.

1.

18 V.S.A.

CLINICAL DECISION MAKING §§ 9771. 9771.

BILL AS PASSED BY THE HOUSE H.583 Page 27 of 39 (2) “Health care provider” has the same meaning as in section 9402 of this title.

VT LEG #388217 v.1 AS PASSED BY HOUSE H.583 Page 2 of 14 (C) performance of functions to refer, arrange, and coordinate care;

BILL AS PASSED BY THE HOUSE H.583 Page 28 of 39 (5)(A) “Hedge fund” means a pool of funds managed by investors for the purpose of earning a return on those funds, regardless of the strategies used to manage the funds.

or VT LEG #388217 v.1 AS PASSED BY HOUSE H.583 Page 3 of 14 (ii) entities that solely provide or manage debt financing secured in whole or in part by the assets of a health care facility, including banks, credit unions, commercial real estate lenders, bond underwriters, and trustees.

BILL AS PASSED BY THE HOUSE H.583 Page 29 of 39 (B) interest held by an investor or group of investors who engage in the raising or returning of capital and who invest, develop, or dispose of specified assets;

(8)(A) “Private equity group” means an investor or group of investors who primarily engage in the raising or returning of capital and who invest, develop, dispose of, or purchase any equity interest in assets, either as a parent VT LEG #388217 v.1 AS PASSED BY HOUSE H.583 Page 4 of 14 company or through another entity the investor or investors completely or partially own or control.

(9) “Provider organization” means any corporation, partnership, business trust, association, or organized group of persons that is in the business of health care delivery or management, whether incorporated or not, that represents one or more health care providers in contracting with health BILL AS PASSED BY THE HOUSE H.583 Page 30 of 39 insurers for payment for health care services.

VT LEG #388217 v.1 AS PASSED BY HOUSE H.583 Page 5 of 14 (B) an investor, group of investors, or other entity with a direct or indirect possession of equity in the capital, stock, or profits totaling more than 10 percent of a health care provider or provider organization;

§§ 9772. 9772.

LIMITATIONS ON CONTROL OVER CLINICAL DECISION MAKING BY PRIVATE EQUITY GROUP OR HEDGE FUND BILL AS PASSED BY THE HOUSE H.583 Page 31 of 39 (a) The purpose of this section is to ensure that clinical decision making and treatment decisions are exclusively in the hands of health care providers and to safeguard against nonlicensed individuals or entities, such as private equity groups and hedge funds, exerting influence or control over health care delivery.

VT LEG #388217 v.1 AS PASSED BY HOUSE H.583 Page 6 of 14 (1) interfere with the judgment of health care providers in making health care decisions, including any of the following:

or BILL AS PASSED BY THE HOUSE H.583 Page 32 of 39 (2) exercise control over, or be delegated the power to do, any of the following:

VT LEG #388217 v.1 AS PASSED BY HOUSE H.583 Page 7 of 14 (D) setting the parameters under which a health care provider or health care facility shall enter into contractual relationships with third-party payers;

BILL AS PASSED BY THE HOUSE H.583 Page 33 of 39 (c) A private equity group or hedge fund, or an entity controlled directly in whole or in part by a private equity group or hedge fund, shall not enter into an agreement or arrangement with a health care facility doing business in this State if the agreement or arrangement would enable the person to interfere with the ability of health care providers to make health care decisions, as set forth in subdivision (b)(1) of this section, or to exercise control over or be delegated the powers set forth in subdivision (b)(2) of this section.

VT LEG #388217 v.1 AS PASSED BY HOUSE H.583 Page 8 of 14 (d)(1) The organizational form of a health care facility as a sole proprietorship, partnership, foundation, or corporate entity of any kind shall not affect the applicability of this section.

BILL AS PASSED BY THE HOUSE H.583 Page 34 of 39 (e) A health care provider who is aggrieved by the actions of a private equity group or hedge fund, or an entity controlled directly in whole or in part by a private equity group or hedge fund, in violation of this section may bring an action in Superior Court for appropriate equitable relief, actual damages, reasonable costs, and attorney’s fees.

VT§ 9773. LEG #388217 v.1 AS PASSED BY HOUSE H.583 Page 9 of 14 § 9773.

(b) Each health care facility or management services organization in which one or more private equity groups or hedge funds holds an ownership or BILL AS PASSED BY THE HOUSE H.583 Page 35 of 39 investment interest as of June 1, 2026, shall report the following information to the Green Mountain Care Board, in a form and manner required by the Board:

VT LEG #388217 v.1 AS PASSED BY HOUSE H.583 Page 10 of 14 (A) has an ownership or investment interest;

BILL AS PASSED BY THE HOUSE H.583 Page 36 of 39 (1) a private equity group or hedge fund takes on an ownership or investment interest in the health care facility or management services organization that had not previously been reported to the Green Mountain Care Board in accordance with subsection (b) of this section;

or VT LEG #388217 v.1 AS PASSED BY HOUSE H.583 Page 11 of 14 (2) there is a modification to a private equity group’s or hedge fund’s existing ownership or investment interest in the health care facility or management services organization.

§§ 7102; 7102;

§§ 4098a, 4098a, and all forms of remote patient monitoring.

(1) any individual health care provider’s taxpayer ID that is also the individual’s Social Security number, and any nonbusiness telephone number, BILL AS PASSED BY THE HOUSE H.583 Page 37 of 39 email address, physical address, or mailing address of any individual health care provider, shall be exempt from public inspection and copying under the Public Records Act and shall be kept confidential;

and VT LEG #388217 v.1 AS PASSED BY HOUSE H.583 Page 12 of 14 (2) all profit and loss statements and balance sheets submitted pursuant to subdivision (b)(3) of this section shall be exempt from public inspection and copying under the Public Records Act and shall be kept confidential, except that that the Board shall provide copies of these materials, or the information contained in them, to the Office of the Health Care Advocate, which shall not further disclose this confidential information.

VTBILL LEG #388217 v.1 AS PASSED BY THE HOUSE H.583 Page 1338 of 1439 §§ 9774. 9774.

VTBILL LEG #388217 v.1 AS PASSED BY THE HOUSE H.583 Page 1439 of 1439 (b) Information provided pursuant to this section shall be public information and shall not be considered confidential, proprietary, or a trade secret;

VT LEG #388217 v.1