Revision: Feb. 4, 2026, 5:27 p.m.
SB 666-FN - AS INTRODUCED
2026 SESSION
26-3268
05/09
SENATE BILL 666-FN
SPONSORS: Sen. Altschiller, Dist 24; Sen. Fenton, Dist 10; Sen. Perkins Kwoka, Dist 21; Sen. Rosenwald, Dist 13; Sen. Reardon, Dist 15; Sen. Long, Dist 20; Sen. Watters, Dist 4; Sen. Prentiss, Dist 5
COMMITTEE: Health and Human Services
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ANALYSIS
This bill:
I. Defines and regulates material health care transactions, and requires notice to the department of justice of health care transactions that change of control of a health care entity and that may reasonably be expected to affect competition, cost of health care services, or access to care. The bill authorizes the department to review, monitor, and approve such transactions and enforce violations of the regulatory requirements as a violation of the consumer protection act.
II. Establishes a legislative committee to study health insurance providers, their practices, policies, premiums, management, and the impact to consumers.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
26-3268
05/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty-Six
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Short Title. This act shall be known as the "Keep Wall Street Out of Health Care Act".
2 Purpose. The purpose of this act is to:
I. Protect consumers of health care services in New Hampshire from anticompetitive consolidation, excessive cost increases, and reductions in access or quality of care;
II. Provide enhanced oversight of material health care transactions, including those involving private equity and for-profit ownership;
III. Ensure transparency in ownership, financing, and control of health care providers;
IV. Preserve the independent clinical judgment of licensed health care professionals; and
V. Establish a study committee to analyze health insurance providers, their practices, policies, premiums, management, and the impact to consumers.
3 New Chapter; Regulation of Material Health Care Transactions. Amend RSA by inserting after chapter 358-T the following new chapter:
CHAPTER 358-U
REGULATION OF MATERIAL HEALTH CARE TRANSACTIONS
358-U:1 Definitions. In this chapter:
I. "Affected health care entity" means any hospital, health system, clinic, ambulatory surgical center, urgent care center, diagnostic facility, physician practice, or other entity licensed or certified to provide health care services in this state.
II. "Change of control" means any transaction or series of transactions that results in a person or entity obtaining direct or indirect control of an affected health care entity, including through:
(a) Equity acquisition;
(b) Merger or consolidation;
(c) Management services agreement; or
(d) Any arrangement conferring operational or financial control.
III. ''Department" means the department of justice, consumer protection and antitrust bureau.
IV. "For-profit health care transaction" means a material health care transaction resulting in full or partial ownership or control by a for-profit entity.
V. "Material health care transaction" means a change of control or affiliation involving an affected health care entity that may reasonably be expected to materially affect:
(a) Competition;
(b) Cost of health care services;
(c) Access to care; or
(d) Quality or continuity of care in this state.
VI. "Private equity entity" means any investment fund, partnership, or similar vehicle that acquires or holds an ownership or controlling interest in an affected health care entity and is not itself a licensed health care provider.
358-U:2 Advance Notice of Material Health Care Transaction Required.
I. Parties engaging in a material health care transaction shall file written notice with the department at least 60 days prior to the proposed closing date.
II. Notice shall be required for:
(a) Any change of control involving an affected health care entity;
(b) Any material transaction involving a private equity entity; and
(c) Any material transaction involving a for-profit health care entity.
358-U:3 Disclosure and Reporting Requirements. Each notice filed pursuant to RSA 358-U:2 shall include:
I. A description of the proposed transaction and transaction structure.
II. Identification of all parties and affiliated entities.
III. A complete description of ownership and control structures, including all private equity investors and funds.
IV. All debt financing arrangements associated with the transaction, including:
(a) Lenders.
(b) Amounts.
(c) Material terms.
V. Disclosure of any planned or anticipated dividends, management fees, or other upstream distributions.
VI. A market impact statement assessing:
(a) Competitive effects.
(b) Expected changes in costs to consumers.
(c) Effects on access and service availability.
(d) Anticipated changes to staffing or clinical services.
358-U:4 Department of Justice Review and Authority.
I. The department shall review a material health care transaction within 30 days of receipt of notice under RSA 358-U:2 to determine its likely impact on:
(a) Competition and market concentration;
(b) Cost of care to consumers and payors;
(c) Access to services, including in rural or underserved areas;
(d) Quality and continuity of care; and
(e) Financial stability of the affected health care entity.
II. Following review, the department may prohibit the transaction if it is likely to substantially lessen competition or otherwise harm consumers' quality of care, accessibility, or cost of care.
III. Conditions imposed under this section may include, but are not limited to:
(a) Limits on service reductions or facility closures;
(b) Requirements related to staffing levels or service availability;
(c) Restrictions on debt levels or upstream distributions and dividends; and
(d) Ongoing reporting or compliance monitoring.
358-U:5 Protection of Independent Clinical Judgment.
I. No private equity entity, for-profit owner, or management services organization shall interfere with, direct, or control the professional clinical judgment of a licensed health care professional in the diagnosis, treatment, or care of a patient.
II. Prohibited interference includes, but is not limited to:
(a) Requiring adherence to non-clinical productivity quotas that compromise patient
care.
(b) Conditioning compensation on reducing medically necessary services.
(c) Restricting referrals, admissions, or treatments for non-clinical financial reasons.
(d) Mandating care protocols inconsistent with generally accepted standards of practice.
III. Nothing in this section shall prohibit:
(a) Administrative or billing oversight;
(b) Compliance with evidence-based clinical guidelines developed by licensed professionals; or
(c) Utilization review required by state or federal law, provided such review does not override clinical judgment.
358-U:6 Enforcement and Remedies.
I. The department may enforce this chapter through civil actions seeking:
(a) Injunctive relief;
(b) Civil penalties;
(c) Divestiture or rescission of transactions; and
(d) Any other relief authorized by law, including RSA 358-A.
II. A health care professional or consumer harmed by a violation of RSA 358-U:5 may bring a civil action for injunctive relief.
III. A violation of this chapter shall constitute an unfair or deceptive act under RSA 358-A and any right or remedy available under RSA 358-A may be used to enforce this chapter.
358-U:7 Annual Report. Beginning November 1, 2027, and annually thereafter, the attorney general shall submit an annual report to the governor, the commissioner of the department of health and human services, the senate president, and the speaker of the house of representatives summarizing:
I. Transactions reviewed under this chapter;
II. Actions taken;
III. Observed trends in private equity and for-profit health care ownership; and
IV. Any recommendations for legislative action.
4 Health Insurance Study Committee Established.
I. There is hereby established a health insurance study committee to assess private health insurers and their impact to the health care marketplace, consumers, and patients.
II. The members of the committee shall be as follows:
(a) Three members of the senate, appointed by the president of the senate.
(b) Two members of the house of representatives, appointed by the speaker of the house of representatives.
III. Members of the committee shall receive mileage at the legislative rate when attending to the duties of the committee.
IV. The committee shall:
(a) Study how private health insurers' practices, policies, premiums, and management functions with regard to the impact to consumers'/patients' coverage, care outcomes, and costs.
(b) Make recommendations regarding policies, regulations, or legislation to mitigate negative impacts and maximize public benefit.
V. The members of the study committee shall elect a chairperson from among the members. The first meeting of the committee shall be called by the first-named senate member. The first meeting of the committee shall be held within 45 days of the effective date of this section. Three members of the committee shall constitute a quorum.
VI. Notwithstanding RSA 14:49, I(b), on or before November 30, 2026, the committee shall report its findings and any recommendations for proposed legislation to the president of the senate, the speaker of the house of representatives, the senate clerk, the house clerk, the governor, and the state library.
5 Severability. If any provision of this act or the application thereof to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of the act which can be given effect without the invalid provisions or applications, and to this end the provisions of this act are severable.
I. Section 4 of this act shall take effect upon its passage.
II. The remainder of this act shall take effect July 1, 2027.
26-3268
02/03/2026
SB 666-FN- FISCAL NOTE
AS INTRODUCED
FISCAL IMPACT:
The Office of Legislative Budget Assistant is unable to complete a fiscal note for this bill as it is awaiting information from the Department of Justice. The Department was contacted on 02/03/2026 for a fiscal note worksheet. When completed, the fiscal note will be forwarded to the Senate Clerk's Office.
AGENCIES CONTACTED:
Department of Justice