CT/CA/NYC/VT/States Advance PE Curbs; MSO Scrutiny & FMV Risks; FTC Antitrust Action; REIT/Sale-Leaseback Legislation Wave
Key Questions
What new regulations target private equity involvement in healthcare transactions?
California's OHCA proposed emergency regulations expanding pre-transaction notice to PE firms and MSOs under AB 1415. Connecticut SB 196 requires hospitals to attest no PE controlling interest and limits PE influence on clinical decisions. Over 42 state bills and new CPOM measures in states like WA, RI, VT, and IL add to scrutiny.
How does Connecticut's law address PE sale-leaseback tactics?
SB 196 was signed after the Prospect debacle and requires hospitals to confirm no PE controlling interest while restricting PE influence on clinical decisions. It is the first state law in a 2026 wave targeting REITs and sale-leasebacks, reducing REIT appetite and raising cost of capital.
What antitrust actions has the FTC taken against healthcare deals?
The FTC forced Ascension to divest 7 ASCs in its $3.9B AmSurg deal, including a compliance monitor as a concrete remedy. State antitrust enforcement is also rising alongside federal efforts.
What do studies show about private equity's impact on healthcare prices and quality?
A review of 46 studies found PE ownership leads to price increases and mostly harmful or mixed quality outcomes. This reinforces regulatory and reputational risks for PE-backed providers.
How are states responding to PE in nursing homes and oncology?
After nursing home crises, states are targeting PE's role, with Connecticut's law as the strongest example. In oncology, site-neutral policies and 340B reforms are driving a shift back to PE-backed independence, with 10% of clinics now PE-affiliated.
California's OHCA released proposed emergency regulations implementing AB 1415, expanding pre-transaction notice to PE firms and MSOs. Connecticut SB 196 signed into law, directly targeting PE sale-leaseback tactics after Prospect debacle—requires hospitals to attest no PE controlling interest and limits PE influence on clinical decisions. A growing 2026 legislative wave targets REITs and sale-leasebacks, with Connecticut as first to enact; federal bills also introduced. This reduces REIT appetite, raising cost of capital. CA AG Bonta CPOM ruling; 42+ state bills. Oregon oversight ineffective; Delaware SB1 advances transparency. New CPOM bills in WA, RI, VT, IL. State antitrust enforcement rising. ACP position paper calls for mandatory disclosure. FTC forced Ascension to divest 7 ASCs in $3.9B AmSurg deal—concrete antitrust remedy with compliance monitor. NY PA scope-of-practice proposal. NY FY27 budget includes $1.5B healthcare investment, CON streamlining, AI consortium, temporary staffing crackdown. A comprehensive lit review of 46 studies confirms PE in healthcare leads to price increases and mixed quality outcomes, mostly harmful—reinforcing regulatory and reputational risks. After nursing home crises, states target PE’s role in skilled nursing, with Connecticut’s law as strongest example. PE in oncology: shift from hospital employment back to PE-backed independence driven by site-neutral policies and 340B reforms; 10% of oncology clinics PE-affiliated. Ohio Medicaid fraud prevention initiatives add to state-level regulatory moves. A new article on PE/REITs in nursing homes ('Bodies in the Beds') underscores mounting scrutiny.