Read the full stored bill text
LCO No. 1479 1 of 14
General Assembly Raised Bill No. 5398
February Session, 2026 LCO No. 1479
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT CONCERNING THE REVIEW OF HEALTH CARE ENTITY
TRANSACTIONS, THE EXPANSION OF EQUITABLE RELIEF AND
ENFORCEMENT TOOLS AVAILABLE UNDER THE CONNECTICUT
ANTITRUST ACT AND THE INCLUSION OF ADDITIONAL
INFORMATION IN HOSPITAL PRICEMASTER FILINGS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-486i of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective October 1, 2026): 2
(a) As used in this section: 3
(1) "Advanced practice registered nurse" means an advanced practice 4
registered nurse licensed pursuant to chapter 378; 5
[(1)] (2) "Affiliation" means the formation of a relationship between 6
two or more entities that permits the entities to negotiate jointly with 7
third parties over rates for professional medical services; 8
[(2)] (3) "Captive professional entity" means a partnership, 9
professional corporation, limited liability company or other entity 10
formed to render professional services in which a partner, a member, a 11
Raised Bill No. 5398
LCO No. 1479 2 of 14
shareholder or a beneficial owner is a physician, directly or indirectly, 12
employed by, controlled by, subject to the direction of, or otherwise 13
designated by (A) a hospital, (B) a hospital system, (C) a medical school, 14
(D) a medical foundation, organized pursuant to subsection (a) of 15
section 33-182bb, or (E) any entity that controls, is controlled by or is 16
under common control with, whether through ownership, governance, 17
contract or otherwise, another person, entity or organization described 18
in subparagraphs (A) to (D), inclusive, of this subdivision; 19
(4) "Entity" has the same meaning as provided in section 33-602; 20
(5) "Group practice" means two or more physicians, legally organized 21
in a partnership, professional corporation, limited liability company 22
formed to render professional services, medical foundation, not -for-23
profit corporation, faculty practice plan or other similar entity (A) in 24
which each physician who is a member of the group provides 25
substantially the full range of services that the physician routinely 26
provides, including, but not limited to, medical care, consultation, 27
diagnosis or treatment, through the joint use of shared office space, 28
facilities, equipment or personnel; (B) for which substantially all of the 29
services of the physicians who are members of the group are provided 30
through the group and are billed in the name of the group practice and 31
amounts so received are treated as receipts of the group; or (C) in which 32
the overhead expenses of, and the income from, the group are 33
distributed in accordance with methods previously determined by 34
members of the group. An entity that otherwise meets the definition of 35
group practice under this section shall be considered a group practice 36
although its shareholders, partners or owners of the group practice 37
include single -physician professional corporations, limited liability 38
companies formed to render professional services or other entities in 39
which beneficial owners are individual physicians; 40
(6) "Health care entity" means a health care provider, health care 41
facility, as defined in section 19a -630, provider organization, group 42
practice or pharmacy benefit manager, as defined in section 38a-479aaa. 43
Raised Bill No. 5398
LCO No. 1479 3 of 14
As used in this subdivision, "provider organization" means any 44
corporation, partnership, business trust, association or organized group 45
of persons, including, but not limited to, a physician organization, a 46
physician-hospital organization, an independent practice organization, 47
a provider network, an accountable care organization or a management 48
services organization, that is in the business of health care delivery or 49
management, whether incorporated or not, and that represents one or 50
more health care providers in contracting with health carriers for the 51
payment of health care services; 52
(7) "Health care provider" has the same meaning as provided in 53
section 19a-17b; 54
[(3)] (8) "Hospital" (A) has the same meaning as provided in section 55
19a-646, or (B) means a facility licensed as a hospital pursuant to the 56
laws of another state; 57
[(4)] (9) "Hospital system" means: (A) A parent corporation of one or 58
more hospitals and any entity affiliated with such parent corporation 59
through ownership, governance or membership; or (B) a hospital and 60
any entity affiliated with such hospital through ownership, governance 61
or membership; 62
[(5) "Health care provider" has the same meaning as provided in 63
section 19a-17b;] 64
(10) "Management services organization" means an entity that 65
provides management, administrative support and other services to a 66
group practice, hospital, hospital system, captive professional entity, 67
medical foundation or other entity organized by, controlled by or 68
otherwise affiliated with such hospital or hospital system pursuant to a 69
contract or other agreement; 70
[(6)] (11) "Medical foundation" means a medical foundation formed 71
under chapter 594b; 72
Raised Bill No. 5398
LCO No. 1479 4 of 14
[(7) "Physician" has the same meaning as provided in section 20-13a;] 73
(12) "Nurse -midwife" means a nurse -midwife licensed pursuant to 74
chapter 377; 75
[(8)] (13) "Person" has the same meaning as provided in section 35-25; 76
(14) "Physician" has the same meaning as provided in section 20-13a; 77
(15) "Physician assistant" means a physician assistant licensed 78
pursuant to chapter 370; 79
[(9)] (16) "Professional corporation" has the same meaning as 80
provided in section 33-182a; 81
[(10) "Group practice" means two or more physicians, legally 82
organized in a partnership, professional corporation, limited liability 83
company formed to render professional services, medical foundation, 84
not-for-profit corporation, faculty practice plan or other similar entity 85
(A) in which each physician who is a member of the group provides 86
substantially the full range of services that the physician routinely 87
provides, including, but not limited to, medical care, consultation, 88
diagnosis or treatment, through the joint use of shared office space, 89
facilities, equipment or personnel; (B) for which substantially all of the 90
services of the physicians who are members of the group are provided 91
through the group and are billed in the name of the group practice and 92
amounts so received are treated as receipts of the group; or (C) in which 93
the overhead expenses of, and the income from, the group are 94
distributed in accordance with methods previously determined by 95
members of the group. An entity that otherwise meets the definition of 96
group practice under this section shall be considered a group practice 97
although its shareholders, partners or owners of the group practice 98
include single -physician professional corporations, limited liability 99
companies formed to render professional services or other entities in 100
which beneficial owners are individual physicians; and] 101
Raised Bill No. 5398
LCO No. 1479 5 of 14
[(11)] (17) "Primary service area" means the smallest number of zip 102
codes from which the [group practice] health care entity draws at least 103
seventy-five per cent of its patients; and 104
(18) "Private equity entity" means any entity that collects capital 105
investments from individuals or entities and purchases, as a parent 106
company or through another entity that the private equity entity 107
completely or partially owns or controls, a direct or indirect ownership 108
share of a health care entity or management services organization. 109
"Private equity entity" does not include a venture capital firm 110
exclusively funding a start -up company or any other early -stage 111
business. 112
(b) At the same time that any person conducting business in this state 113
that files merger, acquisition or any other information regarding market 114
concentration with the Federal Trade Commission or the United States 115
Department of Justice, in compliance with the Hart -Scott-Rodino 116
Antitrust Improvements Act, 15 USC 18a, where a hospital, hospital 117
system or other health care provider is a party to the merger or 118
acquisition that is the subject of such information, such person shall 119
provide written notification [to the Attorney General] of such filing and 120
[, upon the request of the Attorney General, provide ] a copy of such 121
merger, acquisition or other information to the Attorney General. 122
(c) Not less than [thirty] sixty days prior to the effective date of any 123
transaction that results in a material change to the business or corporate 124
structure of a group practice, the parties to the transaction shall submit 125
[written notice] to the Attorney General written notice of such material 126
change and each survey analysis, study document and report that was 127
prepared by or for any officer or director of each party to the transaction 128
for the purpose of evaluating the transaction with respect to market 129
shares, competitors, potential for sales growth or expansion into 130
product or geographic markets . For purposes of this subsection, a 131
[material change to the business or corporate structure of a group 132
practice] "material change to the business or corporate structure of a 133
Raised Bill No. 5398
LCO No. 1479 6 of 14
group practice " includes: (1) The merger, consolidation or other 134
affiliation of a group practice with (A) another group practice that 135
results in a group practice comprised of eight or more physicians, or (B) 136
a hospital, hospital system, captive professional entity, medical 137
foundation or other entity organized or controlled by such hospital or 138
hospital system; (2) the acquisition of all or substantially all of (A) the 139
properties and assets of a group practice, or (B) the capital stock, 140
membership interests or other equity interests of a group practice by (i) 141
another group practice that results in a group practice comprised of 142
eight or more physicians, or (ii) a hospital, hospital system, captive 143
professional entity, medical foundation or other entity organized or 144
controlled by such hospital or hospital system; (3) the employment of all 145
or substantially all of the physicians of a group practice , or of a 146
department o r division of a group practice, by (A) another group 147
practice that results in a group practice comprised of eight or more 148
physicians, or (B) a hospital, hospital system, captive professional entity, 149
medical foundation or other entity organized by, controlled by or 150
otherwise affiliated with such hospital or hospital system, including, but 151
not limited to, through a transfer of ownership of such group practice to 152
such hospital, hospital system, captive professional entity, medical 153
foundation or other entity ; and (4) the acquisition of one or more 154
insolvent group practices by (A) another group practice that results in a 155
group practice comprised of eight or more physicians, or (B) a hospital, 156
hospital system, captive professional entity, medical foundation or 157
other entity organized by, controlled by or otherwise affiliated with 158
such hospital or hospital system. 159
(d) (1) The written notice of a material change required under 160
subsection (c) of this section shall identify each party to the transaction 161
and describe the material change as of the date of such notice to the 162
business or corporate structure of the group practice, including: (A) A 163
description of the nature of the proposed relationship among the parties 164
to the proposed transaction; (B) the names and specialties of each 165
physician, physician assistant, advanced practice registered nurse and 166
Raised Bill No. 5398
LCO No. 1479 7 of 14
nurse-midwife that is a member of the group practice that is the subject 167
of the proposed transaction and who will practice [medicine] with the 168
resulting group practice, hospital, hospital system, captive professional 169
entity, medical foundation or other entity organized by, controlled by, 170
or otherwise affiliated with such hospital or hospital system following 171
the effective date of the transaction; (C) the names of the business 172
entities that are to provide services following the effective date of the 173
transaction; (D) the address for each location where such services are to 174
be provided; (E) a description of the services to be provided at each such 175
location; [and] (F) the primary service area to be served by each such 176
location; (G) the names of each individual or entity that holds a direct or 177
indirect ownership interest of five per cent or more of the resulting 178
health care entity organized by, controlled by or otherwise affiliated 179
with such hospital or hospital system following the effective date of the 180
transaction; and (H) the name and scope of services provided by any 181
entity serving as a management service organization for the resulting 182
health care entity or other entity organized by, controlled by or 183
otherwise affiliated with such hospital or hospital system following the 184
effective date of the transaction. 185
(2) Not later than thirty days after the effective date of any transaction 186
described in subsection (c) of this section, the parties to the transaction 187
shall submit written notice to the Commissioner of Health Strategy. 188
Such written notice shall include, but need not be limited to, the same 189
information described in subdivision (1) of this subsection. The 190
commissioner shall post a link to such notice on the Office of Health 191
Strategy's Internet web site. 192
(e) Not less than [thirty] sixty days prior to the effective date of any 193
transaction that results in (1) an affiliation between one hospital or 194
hospital system and another hospital or hospital system, (2) a transfer 195
that impacts or changes the governance or controlling body of a hospital 196
or hospital system, including, but not limited to, any affiliation or 197
merger, or (3) a transfer of a controlling interest in any entity that 198
possesses or controls, directly or indirectly, an interest of at least twenty 199
Raised Bill No. 5398
LCO No. 1479 8 of 14
per cent of a health care facility, the parties to the affiliation or transfer 200
shall submit written notice to the Attorney General of such affiliation. 201
Such written notice shall identify each party to the affiliation and 202
describe the affiliation as of the date of such notice, including: [(1)] (A) 203
A description of the nature of the proposed relationship among the 204
parties to the affiliation; [(2)] (B) the names of the business entities that 205
are to provide services following the effective date of the affiliation; [(3)] 206
(C) the address for each location where such services are to be provided; 207
[(4)] (D) a description of the services to be provided at each such 208
location; and [(5)] (E) the primary service area to be served by each such 209
location. For any transaction that requires a cost and market impact 210
review under section 19a-639f, the Attorney General may extend review 211
under this section until thirty days after the release of the final report on 212
the cost and market impact review. 213
(f) Not less than sixty days prior to the effective date of any material 214
change transaction, or a series of related transactions that occur within 215
a five-year period and that, taken together, would amount to a material 216
change transaction, involving a health care entity in the state that either 217
has total assets, annual revenues or anticipated annual revenues for new 218
entities of at least ten million dollars, including both in-state and out-of-219
state assets or revenues, or that includes a private equity entity, the 220
parties to such transaction shall submit a written notice to the Attorney 221
General of such material change transaction. For purposes of this 222
subsection, "material change transaction" includes: (1) A corporate 223
merger involving one or more health care entities; (2) an acquisition of 224
one or more health care entities, including, but not limited to, insolvent 225
health care entities, by direct or indirect purchase in any manner, 226
including, but not limited to, lease, transfer, exchange, option, receipt of 227
a conveyance, creation of a joint venture or any other manner of 228
purchase, such as by a health care system, private equity group, hedge 229
fund, publicly traded company, real estate investment trust, 230
management services organization or health carrier, or any subsidiaries 231
thereof, of not less than twenty per cent of the assets or operations of a 232
Raised Bill No. 5398
LCO No. 1479 9 of 14
health care entity; (3) any affiliation, arrangement or contract that results 233
in a change of control of a health care entity by an arrangement or 234
agreement in which any other person, corporation, partnership or entity 235
acquires direct or indirect control over the operations of a health care 236
entity in whole or in substantial part; (4) the formation of a partnership, 237
joint venture, accountable care organization, parent organization or 238
management services organization for the purpose of administering 239
contracts with health carriers, third -party administrators, pharmacy 240
benefit managers or health care providers; (5) a sale, purchase, lease, 241
affiliation or transfer of control of a board of directors or governing body 242
of a health care entity; or (6) a real estate sale or lease agreement 243
involving not less than twenty per cent of the assets of a health care 244
entity. 245
[(f)] (g) The Attorney General may request the submission of any 246
additional information that is necessary to carry out the Attorney 247
General's responsibilities under this section. Written information 248
submitted to the Attorney General pursuant to this subsection and 249
subsections (b) to [(e)] (f), inclusive, of this section shall be maintained 250
and used by the Attorney General in the same manner as provided in 251
section 35-42, except the Attorney General may share such information 252
with the Commissioner of Health Strategy to receive consultation on 253
any aspect of the Attorney General's review under this section. Any such 254
shared information, including, but not limited to, documentary 255
material, shall be held in the custody of the Office of Health Strategy , 256
and shall not be available to the public in the same manner as provided 257
in section 35-42. 258
(h) The Attorney General, in reviewing any notice or information 259
submitted under this section, shall (1) evaluate a transaction's 260
compliance with antitrust laws, and (2) if the transaction would not 261
otherwise require a certificate of need under section 19a -638, consult 262
with the Office of Health Strategy regarding the effect of the transaction 263
on access, quality and affordability of health care in the parties' primary 264
service areas. 265
Raised Bill No. 5398
LCO No. 1479 10 of 14
(i) If the Attorney General identifies any issues of concern in his or 266
her evaluation of a transaction under subsection (h) of this section, the 267
Attorney General may offer the parties conditions to meet for the 268
transaction to proceed unchallenged, provided the Attorney General 269
deems such conditions appropriate. 270
[(g)] (j) Not later than January [15, 2018, and ] first annually, 271
[thereafter,] each hospital and hospital system shall file with the 272
Attorney General and the Commissioner of Health Strategy a written 273
report describing the activities of the group practices owned or affiliated 274
with such hospital or hospital system. Such report shall include, for each 275
such group practice: (1) A description of the nature of the relationship 276
between the hospital or hospital system and the group practice; (2) the 277
names and specialties of each physician , physician assistant, advanced 278
practice registered nurse and nurse-midwife practicing [medicine] with 279
the group practice; (3) the names of the business entities that provide 280
services as part of the group practice and the address for each location 281
where such services are provided; (4) a description of the services 282
provided at each such location; and (5) the primary service area served 283
by each such location. 284
[(h)] (k) Not later than January [15, 2018, and ] first annually, 285
[thereafter,] each group practice comprised of thirty or more physicians 286
that is not the subject of a report filed under subsection [(g)] (j) of this 287
section shall file with the Attorney General and the Commissioner of 288
Health Strategy a written report concerning the group practice. Such 289
report shall include, for each such group practice: (1) The names and 290
specialties of each physician practicing medicine with the group 291
practice; (2) the names of the business entities that provide services as 292
part of the group practice and the address for each location where such 293
services are provided; (3) a description of the services provided at each 294
such location; and (4) the primary service area served by each such 295
location. 296
[(i)] (l) Not later than January [15, 2018, and ] first annually, 297
Raised Bill No. 5398
LCO No. 1479 11 of 14
[thereafter,] each hospital and hospital system shall file with the 298
Attorney General and the Commissioner of Health Strategy a written 299
report describing each affiliation with another hospital or hospital 300
system. Such report shall include: (1) The name and address of each 301
party to the affiliation; (2) a description of the nature of the relationship 302
among the parties to the affiliation; (3) the names of the business entities 303
that provide services as part of the affiliation and the address for each 304
location where such services are provided; (4) a description of the 305
services provided at each such location; and (5) the primary service area 306
served by each such location. 307
(m) Any person or entity that fails to comply with any provision of 308
this section or wilfully or knowingly gives false or incorrect information 309
shall be subject to fines not to exceed one thousand dollars per day for 310
each day that such person or entity is in violation of this section or for 311
each day that such information is false or incorrect. Any civil penalty 312
authorized by this subsection shall be imposed by the Attorney General 313
and recovered in a civil action brought by the Attorney General. In such 314
civil action, upon application of the Attorney General, the court may 315
grant such equitable relief that the court, in its discretion, determines is 316
necessary or appropriate. 317
(n) Nothing in this section shall be construed to limit or infringe upon 318
the existing authority of any state agency, including, but not limited to, 319
the Office of Health Strategy or the Attorney General, to review any 320
transaction. 321
Sec. 2. Section 35 -29 of the general statutes is repealed and the 322
following is substituted in lieu thereof (Effective October 1, 2026): 323
(a) Every lease, sale or contract for the furnishing of services or for 324
the sale of commodities, or for the fixing of prices charged therefor, or 325
for the giving or selling of a discount or rebate therefrom, on the 326
condition or understanding that the lessee or purchaser shall not deal in 327
the services or the commodities of a competitor or competitors of the 328
Raised Bill No. 5398
LCO No. 1479 12 of 14
lessor or seller, shall be unlawful where the effect of such lease or sale 329
or contract for sale or such condition or understanding may be to 330
substantially lessen competition or tend to create a monopoly in any 331
part of trade or commerce and where such goods or services are for the 332
use, consumption or resale in this state. 333
(b) It shall be unlawful for any corporation to acquire, directly or 334
indirectly, the whole or any part of the stock or assets of another 335
corporation where the effect of such acquisition may be to substantially 336
lessen competition or tend to create a monopoly in any line of 337
commerce. This subsection shall not apply to corporations purchasing 338
such stock solely for investment and not using the same by voting or 339
otherwise to bring about, or in attempting to bring about, the substantial 340
lessening of competition. Nor shall anything contained in this section 341
prevent a corporation from causing the formation of one or more 342
subsidiary corporations for the actual carrying on of its immediate 343
lawful business, or the natural and legitimate branches or extensions 344
thereof, or from owning and holding all or a part of the stock of such 345
subsidiary corporation or corporations , when the effect of such 346
formation is not to substantially lessen competition. In addition to any 347
other remedy provided by this chapter, the Superior Court may order 348
any corporation to divest itself of the stock or assets held contrary to this 349
section, in the manner and within the time fixed by such order. 350
Sec. 3. Section 35 -34 of the general statutes is repealed and the 351
following is substituted in lieu thereof (Effective October 1, 2026): 352
The state or any person, including, but not limited to, a consumer, 353
may sue for equitable relief, including, but not limited to, restitution, 354
disgorgement and injunctive relief, both temporary or permanent, 355
against threatened loss or damage to its property or business by any 356
violation of this chapter. In such actions the court shall follow the rules 357
and principles governing the granting of [injunctive] equitable relief. If 358
the court issues an injunction or orders other equitable relief , the 359
plaintiff shall recover a reasonable attorney's fee together with costs, as 360
Raised Bill No. 5398
LCO No. 1479 13 of 14
determined by the court. 361
Sec. 4. (NEW) (Effective October 1, 2026) In the enforcement of chapter 362
624 of the general statutes, the Attorney General may accept an 363
assurance of voluntary compliance with respect to any method, act or 364
practice deemed in violation of said chapter from any person alleged to 365
be engaged or to have been engaged in such method, act or practice. 366
Such assurance may include an amount as restitution. Thereafter, any 367
evidence of a violation of such assurance shall constitute prima facie 368
proof of violation of the applicable law or right in any action 369
commenced by the Attorney General. 370
Sec. 5. Section 19a -681 of the general statutes is repealed and the 371
following is substituted in lieu thereof (Effective October 1, 2026): 372
(a) For purposes of this section: (1) "Detailed patient bill" means a 373
patient billing statement that includes, in each line item, the hospital's 374
current pricemaster code, a description of the charge and the billed 375
amount; and (2) "pricemaster" means a detailed schedule of hospital 376
charges. 377
(b) Each hospital shall file with the unit its current pricemaster which 378
shall include each charge in its detailed schedule of charges and the 379
corresponding actual cost of each related good or service. 380
(c) Upon the request of the Office of Health Strategy, established 381
under section 19a-754a, or a patient, a hospital shall provide to the office 382
or the patient a detailed patient bill. If the billing detail by line item on 383
a detailed patient bill does not agree with the detailed schedule of 384
charges on file with the unit for the date of service specified on the bill, 385
the hospital shall be subject to a civil penalty of five hundred dollars per 386
occurrence payable to the state not later than fourteen days after the date 387
of notification. The penalty shall be imposed in accordance with section 388
19a-653. The unit may issue an order requiring such hospital, not later 389
than fourteen days after the date of notification of an overcharge to a 390
patient, to adjust the bill to be consistent with the detailed schedule of 391
Raised Bill No. 5398
LCO No. 1479 14 of 14
charges on file with the unit for the date of service specified on the 392
detailed patient bill. 393
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2026 19a-486i
Sec. 2 October 1, 2026 35-29
Sec. 3 October 1, 2026 35-34
Sec. 4 October 1, 2026 New section
Sec. 5 October 1, 2026 19a-681
Statement of Purpose:
To (1) strengthen the review of health care entity transactions, (2)
expand upon the types of equitable relief and other enforcement tools
that may be utilized for violations of the Connecticut Antitrust Act, and
(3) require additional information in hospital pricemaster filings.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]