An Act to Implement Certain Recommendations Related to the Ratio of Debt to Equity in Transactions Involving Health Care Entities from the Commission to Evaluate the Scope of Regulatory Review and Oversight over Health Care Transactions That Impact the Delivery of Health Care Services in the State

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132nd MAINE LEGISLATURE
SECOND REGULAR SESSION-2026
Legislative Document No. 2198
H.P. 1477 House of Representatives, February 10, 2026
An Act to Implement Certain Recommendations Related to the
Ratio of Debt to Equity in Transactions Involving Health Care
Entities from the Commission to Evaluate the Scope of Regulatory
Review and Oversight over Health Care Transactions That Impact
the Delivery of Health Care Services in the State
Reported by Representative MATHIESON of Kittery for the Joint Standing Committee on
Health Coverage, Insurance and Financial Services pursuant to Resolve 2025, chapter 106,
section 8.
Reference to the Committee on Health Coverage, Insurance and Financial Services
suggested and ordered printed pursuant to Joint Rule 218.
ROBERT B. HUNT
Clerk

Page 1 - 132LR3024(01)
1Be it enacted by the People of the State of Maine as follows:
2Sec. 1. 22 MRSA §1730-B is enacted to read:
3§1730-B. Limit on debt-to-equity ratio in transactions with health care entities
41. Definitions. As used in this section, unless the context otherwise indicates, the
5 following terms have the following meanings.
6 A. "Health care entity" means a health care provider, a health care facility or a provider
7 organization. "Health care entity" does not include a nursing facility as defined in
8 section 328, subsection 18.
9 B. "Health care facility" means a licensed institution providing health care services or
10 a health care setting, including, but not limited to, hospitals and other licensed inpatient
11 facilities; health systems consisting of one or more health care entities that are jointly
12 owned or managed; ambulatory surgical or treatment centers; residential treatment
13 centers; diagnostic, laboratory and imaging centers; freestanding emergency facilities;
14 outpatient clinics; and rehabilitation and other therapeutic health settings.
15 C. "Health care provider" means a person, corporation, partnership, governmental unit,
16 state institution, medical practice or other entity qualified or licensed under state law
17 to perform or provide health care services to persons in the State.
18 D. "Provider organization" means any corporation, partnership, business trust,
19 association or organized group of persons that is in the business of health care delivery
20 or management, whether incorporated or not, that represents one or more health care
21 providers in contracting with carriers for the payment of health care services. "Provider
22 organization" includes, but is not limited to, physician organizations, physician-
23 hospital organizations, independent practice associations, health care provider
24 networks, accountable care organizations and management services organizations and
25 any other organization that contracts with carriers for payment for health care services.
262. Debt-to-equity ratio. A person may not enter into any transaction with a health care
27 entity in the State in which the ratio of debt to equity for the health care entity exceeds
28 50%.
29SUMMARY
30 This bill is reported out by the Joint Standing Committee on Health Coverage,
31 Insurance and Financial Services pursuant to Resolve 2025, chapter 106 to implement a
32 recommendation from the Commission to Evaluate the Scope of Regulatory Review and
33 Oversight over Health Care Transactions That Impact the Delivery of Health Care Services
34 in the State. The joint standing committee has not taken a position on the substance of this
35 bill. By reporting this bill out, the joint standing committee is not suggesting and does not
36 intend to suggest that it agrees or disagrees with any aspect of this bill; instead, the joint
37 standing committee is reporting the bill out for the sole purpose of having a bill printed that
38 can be referred to a joint standing committee for an appropriate public hearing and
39 subsequent processing in the normal course. The joint standing committee is taking this
40 action to ensure clarity and transparency in the legislative review of the proposals contained
41 in the bill.
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Page 2 - 132LR3024(01)
1 This bill prohibits any transaction involving a health care entity in which the ratio of
2 debt to equity is greater than 50%.