37 state measures that targeted healthcare consolidation, competition in 2025

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State lawmakers moved aggressively in 2025 to reshape the healthcare marketplace, enacting a wave of legislation aimed at tightening oversight of consolidation, limiting noncompete agreements, curbing private equity influence and revising certificate-of-need laws.

Here are 37 enacted bills related to consolidation and competition, based on data from the National Conference of State Legislatures:

Arkansas

  • H 1653: Updates licensing rules for psychiatric residential treatment facilities and allows exceptions to bed-capacity moratoriums.
  • S 139: Limits enforceability of noncompete agreements for certain licensed medical professionals.

California

  • S 351: Bars private equity and hedge funds from interfering in physicians’ and dentists’ clinical decision-making.

Colorado

  • S 126: Requires state-level filing of federal merger notifications with the attorney general.
  • S 83: Prohibits contracts that restrict providers from informing patients about care options or practice changes.

Connecticut

  • H 7067: Revises emergency CON processes for hospital ownership transfers tied to bankruptcy.

District of Columbia

  • B 25: Exempts certain telehealth and outpatient providers from CON requirements.

Illinois

  • H 1431: Requires hospitals to disclose facility fees for outpatient services.

Indiana

  • H 1666: Expands reporting and oversight of healthcare ownership and mergers.
  • S 119: Allows attorney general review of certificate-of-public-advantage applications with state health officials.
  • S 475: Restricts enforcement of physician noncompete agreements after employment ends.

Iowa

  • H 887: Removes birth centers from CON requirements.
  • H 919: Establishes licensing standards for nonprofit children’s specialty hospitals and exempts them from CON.
  • H 933: Allows pediatric palliative care centers to offer hospice services without CON approval.

Kentucky

  • H 305: Expands eligible healthcare credentials and removes certain EMS CON requirements.
  • H 90: Establishes licensure and standards for freestanding birthing centers.

Maine

  • H 1036: Creates a commission to review healthcare transaction oversight and CON laws.
  • S 416: Imposes a moratorium on private equity and real estate trust ownership of hospitals.

Minnesota

  • H 3: Requires advance notice and disclosures for nonprofit nursing home or assisted living facility sales to for-profit entities.

Montana

  • H 620: Limits post-employment noncompete agreements for healthcare providers.
  • S 88: Updates CON application and public notice processes.

New Hampshire

  • S 172: Prohibits enforcement of certain contract restrictions on advanced practice registered nurses.

New Jersey

  • S 4263: Orders a state study on inpatient commitment bed capacity and CON requirements.

New Mexico

  • H 586: Expands oversight and enforcement authority under the state’s Healthcare Consolidation Oversight Act.

Oklahoma

  • S 873: Revises University Hospitals statutes and creates CON exemptions.

Oregon

  • S 951: Protects clinician autonomy and restricts noncompete and nondisclosure agreements affecting patient care.

Vermont

  • H 96: Raises thresholds triggering CON review and updates project definitions.

Virginia

  • H 1552: Expands exemptions from CON requirements.
  • H 2119: Establishes an expedited CON application and review process.
  • S 1064: Expands expedited CON review for bed changes and psychiatric facilities.
  • S 1177: Further broadens CON exemptions for certain facility actions.
  • S 1203: Creates expedited CON criteria for underserved or low-density areas.
  • S 1218: Limits noncompete agreements and updates employment law provisions.

Washington

  • H 1686: Creates a statewide registry of healthcare entity ownership and control.
  • H 1755: Exempts certain elective cardiac procedures from CON requirements.
  • S 5122: Aligns state antitrust premerger notification rules with federal requirements.

Wyoming

  • S 107: Voids physician noncompete agreements after employment or affiliation ends.
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