Medical businesses would need clinician ownership and control, with exceptions

Covered businesses would need majority clinician ownership and control to own medical practices, hire clinicians, or practice medicine. Clinicians include physicians and advanced practice providers authorized by state law to diagnose and treat patients. Clinician practice owners would need to provide substantial care and be licensed and present in a state where the practice serves patients. Nonprofit and public providers, hospitals, and hospital-affiliated clinics would be exempt from the business ownership restriction. Clinicians would need a majority of ownership interests and governing seats.

Clinicians, health care providers, and management firms could not enter the prohibited agreements. Restrictions on later work include written or oral terms that prevent or penalize taking another job or running a business after employment ends. A practice could enforce a restriction on later work against a clinician shareholder or member, or another clinician who owns or controls at least 25% of the practice. Claims for defamation and other wrongs independent of the prohibited agreements would remain available.

Health care providers could not use pressure, threats, punishment, or retaliation to direct clinicians’ medical decisions. The protections cover physicians and advanced practice providers authorized by state law to diagnose and treat patients. The Federal Trade Commission, consulting with the health secretary, could identify other actions that interfere with clinical judgment.

Medical management firms would face restrictions on practice ownership, control, and contracts. The rules cover paid firms providing practice support, such as payroll, billing, and scheduling, along with their owners, staff, and contractors. Practices would need independently selected legal, negotiating, and financial advisers without financial conflicts involving the firm. Contract payments would need to reflect fair market value as determined by the Federal Trade Commission.

Injured people and state attorneys general could sue to enforce the requirements. People who win could receive three times their damages, legal costs, and other relief. State attorneys general could sue when residents’ interests are harmed or threatened. Courts finding violations would have to order them stopped and, when applicable, require owners to give up an entity and return revenue received from it during the violation. Section 2’s requirements would take effect one year after enactment.