Bill would expand attorney general notice and review of hospital and provider transactions in Washington

A Washington bill that would require more hospital and provider transactions to be reported to the state attorney general advanced through a public hearing Feb. 20 before the Senate Law and Justice Committee.

Representative Jamila Taylor, the bill's prime sponsor, said the measure, Engrossed Substitute House Bill 2,548, is intended to "have eyes on how the healthcare system is changing in Washington state and ensure that we're protecting Washington's access to healthcare." The bill would expand the Consumer Protection Act's notice requirements to include transactions that change majority ownership, transfers of majority assets, conversions from nonprofit to for-profit status and significant asset sales, and would require parties to pay a filing fee when they submit notice.

Ryan Giannini, staff counsel to the committee, told lawmakers the proposal would also require the Attorney General's Office to publicly post quarterly notices of pending and completed material-change transactions and would pause closings when the AG requests additional information until parties certify they have substantially complied with the request.

The Attorney General's antitrust division testified in favor. "This legislation will require all parties to provide notice," Travis Kennedy said, adding that notice should include acquisitions by private equity and commercial insurers that have not previously been required to report under the state pre-merger statute. The AGO's pre-transaction review was identified as the mechanism most directly able to detect potentially anticompetitive mergers or acquisitions that could harm consumers.

Multiple health-sector stakeholders described the bill as a needed transparency tool but suggested refinements. Melissa Johnson of the Washington State Nurses Association warned that private-equity ownership has been linked to staffing cuts and quality problems and said the bill helps ensure "patients deserve to know who controls their care." The Washington State Hospital Association said it supports the bill's clarified scope but flagged concerns about added filing fees.

Officials who regulate insurance and health markets urged the committee to act. Nico Janssen of the Office of the Insurance Commissioner said the OIC found more than 400 private-equity-related transactions since 2020 and supported the bill's public-notice provisions. Patient-advocate groups urged the committee to close perceived oversight gaps; one witness cited a state-level finding that private-equity transactions totaled roughly $42.5 billion across more than 550 deals between 2017 and 2024.

The committee closed the public hearing after dozens of witnesses spoke; the chair reported 125 people signed in pro (not testifying) and 105 signed in con (not testifying). No committee vote on the bill was recorded at the hearing.

If enacted, the change would expand the Attorney General's early-notice review of health-care market transactions and add public reporting and a filing fee; committee members asked technical questions about scope and possible impacts on transactions intended to preserve local services.