Connecticut 2025 Regular Session

Connecticut House Bill HB07224 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1
2	2
3		-	LCO 1 of 11
	3	+	LCO No. 6159 1 of 12
4	4
5		-	General Assembly ~~Substitute~~ Bill No. 7224
	5	+	General Assembly Raised Bill No. 7224
6	6		January Session, 2025
	7	+	LCO No. 6159
	8	+
	9	+
	10	+	Referred to Committee on GOVERNMENT ADMINISTRATION
	11	+	AND ELECTIONS
	12	+
	13	+
	14	+	Introduced by:
	15	+	(GAE)
	16	+
7	17
8	18
9	19
10	20		AN ACT EXPANDING LIABILITY UNDER THE FALSE CLAIMS ACT
11	21		FOR ENTITIES WITH AN OWNERSHIP INTEREST AND PROHIBITING
12	22		THE LICENSING OF HOSPITALS WITH CERTAIN LEASE BACK
13	23		ARRANGEMENTS.
14	24		Be it enacted by the Senate and House of Representatives in General
15	25		Assembly convened:
16	26
17	27		Section 1. Section 4-274 of the general statutes is repealed and the 1
18	28		following is substituted in lieu thereof (Effective October 1, 2025): 2
19	29		As used in this section and section 4-275, as amended by this act: 3
20	30		(1) "Knowing" and "knowingly" means that a person, with respect to 4
21	31		information: (A) Has actual knowledge of the information; (B) acts in 5
22	32		deliberate ignorance of the truth or falsity of the information; or (C) acts 6
23	33		in reckless disregard of the truth or falsity of the information, without 7
24	34		regard to whether the person intends to defraud; 8
25	35		(2) "Claim" (A) means any request or demand, whether under a 9
26	36		contract or otherwise, for money or property and whether or not the 10
27	37		state has title to the money or property, that (i) is presented to an officer, 11
	38	+	Raised Bill No. 7224
	39	+
	40	+
	41	+
	42	+	LCO No. 6159 2 of 12
	43	+
28	44		employee or agent of the state, or (ii) is made to a contractor, grantee or 12
29	45		other recipient, if the money or property is to be spent or used on the 13
30	46		state's behalf or to advance a state program or interest, and if the state 14
31	47		provides or has provided any portion of the money or property that is 15
32	48		requested or demanded, or if the state will reimburse such contractor, 16
33		-	grantee or other recipient for any portion of the money or property that 17 Substitute Bill No. 7224
34		-
35		-
36		-	LCO 2 of 11
37		-
	49	+	grantee or other recipient for any portion of the money or property that 17
38	50		is requested or demanded, and (B) does not include a request or demand 18
39	51		for money or property that the state has paid to an individual as 19
40	52		compensation for state employment or as an income subsidy with no 20
41	53		restrictions on that individual's use of the money or property; 21
42	54		(3) "Person" means any natural person, corporation, limited liability 22
43	55		company, firm, association, organization, partnership, business, trust or 23
44	56		other legal entity; 24
45	57		(4) "State" means the state of Connecticut, any agency or department 25
46	58		of the state or any quasi-public agency, as defined in section 1-120; 26
47	59		(5) "Obligation" means an established duty, whether fixed or not, 27
48	60		arising from (A) an express or implied contractual, grantor-grantee or 28
49	61		licensor-licensee relationship, (B) a fee-based or similar relationship, (C) 29
50	62		statute or regulation, or (D) the retention of an overpayment; [and] 30
51	63		(6) "Material" means having a natural tendency to influence, or be 31
52	64		capable of influencing, the payment or receipt of money or property; 32
53	65		and 33
54	66		(7) "Ownership or investment interest" means any (A) direct or 34
55	67		indirect possession of equity in the capital, stocks or profits totaling 35
56	68		more than ten per cent of an entity, (B) interest held by an investor or 36
57	69		group of investors who engages in the raising or returning of capital and 37
58	70		who invests, develops or disposes of specified assets, or (C) interest held 38
59	71		by a pool of funds by investors, including a pool of funds managed or 39
60	72		controlled by private limited partnerships, if such investors or the 40
61	73		management of such pool or private limited partnership employ 41
62	74		investment strategies of any kind to earn a return on such pool of funds. 42
	75	+	Raised Bill No. 7224
	76	+
	77	+
	78	+
	79	+	LCO No. 6159 3 of 12
	80	+
63	81		Sec. 2. Section 4-275 of the general statutes is repealed and the 43
64	82		following is substituted in lieu thereof (Effective October 1, 2025): 44
65	83		(a) No person shall: 45
66	84		(1) Knowingly present, or cause to be presented, a false or fraudulent 46
67		-	claim for payment or approval; 47 Substitute Bill No. 7224
68		-
69		-
70		-	LCO 3 of 11
71		-
	85	+	claim for payment or approval; 47
72	86		(2) Knowingly make, use or cause to be made or used, a false record 48
73	87		or statement material to a false or fraudulent claim; 49
74	88		(3) Conspire to commit a violation of this section; 50
75	89		(4) Having possession, custody or control of property or money used, 51
76	90		or to be used, by the state, knowingly deliver, or cause to be delivered, 52
77	91		less property than the amount for which the person receives a certificate 53
78	92		or receipt; 54
79	93		(5) Being authorized to make or deliver a document certifying receipt 55
80	94		of property used, or to be used, by the state and intending to defraud 56
81	95		the state, make or deliver such document without completely knowing 57
82	96		that the information on the document is true; 58
83	97		(6) Knowingly buy, or receive as a pledge of an obligation or debt, 59
84	98		public property from an officer or employee of the state who may not 60
85	99		lawfully sell or pledge the property; 61
86	100		(7) Knowingly make, use or cause to be made or used, a false record 62
87	101		or statement material to an obligation to pay or transmit money or 63
88	102		property to the state; [or] 64
89	103		(8) Knowingly conceal or knowingly and improperly avoid or 65
90	104		decrease an obligation to pay or transmit money or property to the state; 66
91	105		or 67
92		-	(9) (A) Have an ownership or investment interest in any corporation, 68
93		-	limited liability company, firm, association, organization, partnership, 69
94		-	business, trust or other legal entity that has violated subdivisions (1) to 70
95		-	(8), inclusive, of this subsection, (B) know about such violation, and (C) 71
96		-	fail to report such violation to the state not later than sixty days after 72
97		-	knowing of such violation. 73
98		-	(b) Any person who violates the provisions of subsection (a) of this 74
99		-	section shall be liable to the state for: (1) A civil penalty of not less than 75
100		-	five thousand five hundred dollars or more than eleven thousand 76
101		-	dollars, or as adjusted from time to time by the federal Civil Penalties 77 Substitute Bill No. 7224
	106	+	(9) (A) Have an ownership or investment interest in any person who 68
	107	+	has violated subdivisions (1) to (8), inclusive, of this section, (B) know 69
	108	+	Raised Bill No. 7224
102	109
103	110
104		-	LCO 4 of 11
105	111
106		-	Inflation Adjustment Act of 1990, 28 USC 2461, (2) three times the 78
107		-	amount of damages that the state sustains because of the act of that 79
108		-	person, and (3) the costs of prosecution of such violation. Liability under 80
109		-	this section shall be joint and several for any violation of this section 81
110		-	committed by two or more persons. 82
111		-	(c) Notwithstanding the provisions of subsection (b) of this section 83
112		-	concerning treble damages, if the court finds that: (1) A person 84
113		-	committing a violation of subsection (a) of this section furnished 85
114		-	officials of the state responsible for investigating false claims violations 86
115		-	with all information known to such person about the violation not later 87
116		-	than thirty days after the date on which the person first obtained the 88
117		-	information; (2) such person fully cooperated with an investigation by 89
118		-	the state of such violation; and (3) at the time such person furnished the 90
119		-	state with the information about the violation, no criminal prosecution, 91
120		-	civil action or administrative action had commenced under sections 4-92
121		-	276 to 4-280, inclusive, with respect to such violation, and such person 93
122		-	did not have actual knowledge of the existence of an investigation into 94
123		-	such violation, the court may assess not less than two times the amount 95
124		-	of damages which the state sustains because of the act of such person. 96
125		-	Any information furnished pursuant to this subsection shall be exempt 97
126		-	from disclosure under section 1-210. 98
127		-	(d) In any civil action, arbitration or other civil proceeding in which 99
128		-	the state is a defendant, the state shall not assert a counterclaim, set-off 100
129		-	or defense alleging a violation of this section. 101
130		-	(e) The provisions of this section shall not apply to any claim, record 102
131		-	or statement made under any tax law administered by this state or a 103
132		-	political subdivision of this state. 104
133		-	Sec. 3. Section 19a-486i of the general statutes is repealed and the 105
134		-	following is substituted in lieu thereof (Effective October 1, 2025): 106
135		-	(a) As used in this section: 107
136		-	(1) "Affiliation" means the formation of a relationship between two or 108 Substitute Bill No. 7224
	112	+	LCO No. 6159 4 of 12
	113	+
	114	+	about such violation, and (C) fail to report such violation to the state not 70
	115	+	later than sixty days after knowing of such violation. 71
	116	+	(b) Any person who violates the provisions of subsection (a) of this 72
	117	+	section shall be liable to the state for: (1) A civil penalty of not less than 73
	118	+	five thousand five hundred dollars or more than eleven thousand 74
	119	+	dollars, or as adjusted from time to time by the federal Civil Penalties 75
	120	+	Inflation Adjustment Act of 1990, 28 USC 2461, (2) three times the 76
	121	+	amount of damages that the state sustains because of the act of that 77
	122	+	person, and (3) the costs of prosecution of such violation. Liability under 78
	123	+	this section shall be joint and several for any violation of this section 79
	124	+	committed by two or more persons. 80
	125	+	(c) Notwithstanding the provisions of subsection (b) of this section 81
	126	+	concerning treble damages, if the court finds that: (1) A person 82
	127	+	committing a violation of subsection (a) of this section furnished 83
	128	+	officials of the state responsible for investigating false claims violations 84
	129	+	with all information known to such person about the violation not later 85
	130	+	than thirty days after the date on which the person first obtained the 86
	131	+	information; (2) such person fully cooperated with an investigation by 87
	132	+	the state of such violation; and (3) at the time such person furnished the 88
	133	+	state with the information about the violation, no criminal prosecution, 89
	134	+	civil action or administrative action had commenced under sections 4-90
	135	+	276 to 4-280, inclusive, with respect to such violation, and such person 91
	136	+	did not have actual knowledge of the existence of an investigation into 92
	137	+	such violation, the court may assess not less than two times the amount 93
	138	+	of damages which the state sustains because of the act of such person. 94
	139	+	Any information furnished pursuant to this subsection shall be exempt 95
	140	+	from disclosure under section 1-210. 96
	141	+	(d) In any civil action, arbitration or other civil proceeding in which 97
	142	+	the state is a defendant, the state shall not assert a counterclaim, set-off 98
	143	+	or defense alleging a violation of this section. 99
	144	+	(e) The provisions of this section shall not apply to any claim, record 100
	145	+	Raised Bill No. 7224
137	146
138	147
139		-	LCO 5 of 11
140	148
141		-	more entities that permits the entities to negotiate jointly with third 109
142		-	parties over rates for professional medical services; 110
143		-	(2) "Captive professional entity" means a partnership, professional 111
144		-	corporation, limited liability company or other entity formed to render 112
145		-	professional services in which a partner, a member, a shareholder or a 113
146		-	beneficial owner is a physician, directly or indirectly, employed by, 114
147		-	controlled by, subject to the direction of, or otherwise designated by (A) 115
148		-	a hospital, (B) a hospital system, (C) a medical school, (D) a medical 116
149		-	foundation, organized pursuant to subsection (a) of section 33-182bb, or 117
150		-	(E) any entity that controls, is controlled by or is under common control 118
151		-	with, whether through ownership, governance, contract or otherwise, 119
152		-	another person, entity or organization described in subparagraphs (A) 120
153		-	to (D), inclusive, of this subdivision; 121
154		-	(3) "Hospital" has the same meaning as provided in section 19a-646; 122
155		-	(4) "Hospital system" means: (A) A parent corporation of one or more 123
156		-	hospitals and any entity affiliated with such parent corporation through 124
157		-	ownership, governance or membership; or (B) a hospital and any entity 125
158		-	affiliated with such hospital through ownership, governance or 126
159		-	membership; 127
160		-	(5) "Health care provider" has the same meaning as provided in 128
161		-	section 19a-17b; 129
162		-	(6) "Medical foundation" means a medical foundation formed under 130
163		-	chapter 594b; 131
164		-	(7) "Physician" has the same meaning as provided in section 20-13a; 132
165		-	(8) "Person" has the same meaning as provided in section 35-25; 133
166		-	(9) "Professional corporation" has the same meaning as provided in 134
167		-	section 33-182a; 135
168		-	(10) "Group practice" means two or more physicians, legally 136
169		-	organized in a partnership, professional corporation, limited liability 137 Substitute Bill No. 7224
	149	+	LCO No. 6159 5 of 12
	150	+
	151	+	or statement made under any tax law administered by this state or a 101
	152	+	political subdivision of this state. 102
	153	+	Sec. 3. Section 19a-486i of the general statutes is repealed and the 103
	154	+	following is substituted in lieu thereof (Effective October 1, 2025): 104
	155	+	(a) As used in this section: 105
	156	+	(1) "Affiliation" means the formation of a relationship between two or 106
	157	+	more entities that permits the entities to negotiate jointly with third 107
	158	+	parties over rates for professional medical services; 108
	159	+	(2) "Captive professional entity" means a partnership, professional 109
	160	+	corporation, limited liability company or other entity formed to render 110
	161	+	professional services in which a partner, a member, a shareholder or a 111
	162	+	beneficial owner is a physician, directly or indirectly, employed by, 112
	163	+	controlled by, subject to the direction of, or otherwise designated by (A) 113
	164	+	a hospital, (B) a hospital system, (C) a medical school, (D) a medical 114
	165	+	foundation, organized pursuant to subsection (a) of section 33-182bb, or 115
	166	+	(E) any entity that controls, is controlled by or is under common control 116
	167	+	with, whether through ownership, governance, contract or otherwise, 117
	168	+	another person, entity or organization described in subparagraphs (A) 118
	169	+	to (D), inclusive, of this subdivision; 119
	170	+	(3) "Hospital" has the same meaning as provided in section 19a-646; 120
	171	+	(4) "Hospital system" means: (A) A parent corporation of one or more 121
	172	+	hospitals and any entity affiliated with such parent corporation through 122
	173	+	ownership, governance or membership; or (B) a hospital and any entity 123
	174	+	affiliated with such hospital through ownership, governance or 124
	175	+	membership; 125
	176	+	(5) "Health care provider" has the same meaning as provided in 126
	177	+	section 19a-17b; 127
	178	+	(6) "Medical foundation" means a medical foundation formed under 128
	179	+	chapter 594b; 129
	180	+	Raised Bill No. 7224
170	181
171	182
172		-	LCO 6 of 11
173	183
174		-	~~company formed to render professional services,~~ ~~medical foundation,~~ ~~138~~
175		-	~~not-for-profit corporation, faculty practice plan or other similar entity 139~~
176		-	(A) in ~~which each physician who is a member of the group provides 140~~
177		-	~~substantially~~ the ~~full range of services that the physician routinely 141~~
178		-	~~provides, including,~~ ~~but not limited to,~~ ~~medical care,~~ ~~consultation, 142~~
179		-	~~diagnosis or treatment,~~ ~~through the joint use of shared office space, 143~~
180		-	~~facilities, equipment~~ or ~~personnel; (B) for which substantially all of the 144~~
181		-	~~services of the physicians who are members of the group are provided 145~~
182		-	~~through the group and are billed in the name of the group practice and 146~~
183		-	~~amounts so received are treated as receipts of the group;~~ or ~~(C) in which 147~~
184		-	~~the overhead expenses~~ of~~, and the income from,~~ the group ~~are 148~~
185		-	~~distributed in accordance with methods previously determined by 149~~
186		-	~~members of the group.~~ ~~An entity that otherwise meets the definition of 150~~
187		-	~~group practice under this section shall be considered a group practice 151~~
188		-	~~although its shareholders~~, ~~partners~~ or ~~owners~~ of the ~~group practice 152~~
189		-	~~include single-physician~~ ~~professional corporations,~~ ~~limited liability 153~~
190		-	~~companies formed to render professional services or other entities~~ in ~~154~~
191		-	~~which beneficial owners~~ are ~~individual physicians~~; ~~[and] 155~~
192		-	~~(11) "Primary~~ ~~service area"~~ ~~means~~ the ~~smallest number of zip codes 156~~
193		-	~~from which the group practice draws at least seventy-five~~ ~~per cent of its 157~~
194		-	~~patients; and 158~~
195		-	~~(12) "Main~~ ~~campus of~~ a ~~hospital" means the licensed premises within 159~~
196		-	~~which~~ the ~~majority of inpatient beds are located. 160~~
197		-	~~(b) At the same time that any person conducting business in this state 161~~
198		-	~~that files merger,~~ ~~acquisition~~ or ~~any~~ other ~~information regarding market 162~~
199		-	~~concentration with the Federal Trade Commission or the United States 163~~
200		-	~~Department~~ of ~~Justice, in compliance with the Hart-Scott-Rodino 164~~
201		-	~~Antitrust Improvements Act,~~ ~~15 USC 18a,~~ ~~where a hospital,~~ ~~hospital 165~~
202		-	~~system or other health care provider is a party to the merger or 166~~
203		-	~~acquisition that is~~ the ~~subject of such information,~~ ~~such person shall 167~~
204		-	~~provide written notification to~~ the ~~Attorney General~~ of ~~such filing and,~~ ~~168~~
205		-	~~upon~~ the ~~request of the Attorney General,~~ ~~provide a copy of such 169~~
206		-	~~merger, acquisition or other information. 170 Substitute~~ Bill No. 7224
	184	+	LCO No. 6159 6 of 12
	185	+
	186	+	(7) "Physician" has the same meaning as provided in section 20-13a; 130
	187	+	(8) "Person" has the same meaning as provided in section 35-25; 131
	188	+	(9) "Professional corporation" has the same meaning as provided in 132
	189	+	section 33-182a; 133
	190	+	(10) "Group practice" means two or more physicians, legally 134
	191	+	organized in a partnership, professional corporation, limited liability 135
	192	+	company formed to render professional services, medical foundation, 136
	193	+	not-for-profit corporation, faculty practice plan or other similar entity 137
	194	+	(A) in which each physician who is a member of the group provides 138
	195	+	substantially the full range of services that the physician routinely 139
	196	+	provides, including, but not limited to, medical care, consultation, 140
	197	+	diagnosis or treatment, through the joint use of shared office space, 141
	198	+	facilities, equipment or personnel; (B) for which substantially all of the 142
	199	+	services of the physicians who are members of the group are provided 143
	200	+	through the group and are billed in the name of the group practice and 144
	201	+	amounts so received are treated as receipts of the group; or (C) in which 145
	202	+	the overhead expenses of, and the income from, the group are 146
	203	+	distributed in accordance with methods previously determined by 147
	204	+	members of the group. An entity that otherwise meets the definition of 148
	205	+	group practice under this section shall be considered a group practice 149
	206	+	although its shareholders, partners or owners of the group practice 150
	207	+	include single-physician professional corporations, limited liability 151
	208	+	companies formed to render professional services or other entities in 152
	209	+	which beneficial owners are individual physicians; [and] 153
	210	+	(11) "Primary service area" means the smallest number of zip codes 154
	211	+	from which the group practice draws at least seventy-five per cent of its 155
	212	+	patients; and 156
	213	+	(12) "Main campus of a hospital" means the licensed premises within 157
	214	+	which the majority of inpatient beds are located. 158
	215	+	(b) At the same time that any person conducting business in this state 159
	216	+	Raised Bill No. 7224
207	217
208	218
209		-	LCO 7 of 11
210	219
211		-	(c) Not less than thirty days prior to the effective date of any 171
212		-	transaction that results in a material change to the business or corporate 172
213		-	structure of a group practice, the parties to the transaction shall submit 173
214		-	written notice to the Attorney General of such material change. For 174
215		-	purposes of this subsection, a material change to the business or 175
216		-	corporate structure of a group practice includes: (1) The merger, 176
217		-	consolidation or other affiliation of a group practice with (A) another 177
218		-	group practice that results in a group practice comprised of eight or 178
219		-	more physicians, or (B) a hospital, hospital system, captive professional 179
220		-	entity, medical foundation or other entity organized or controlled by 180
221		-	such hospital or hospital system; (2) the acquisition of all or 181
222		-	substantially all of (A) the properties and assets of a group practice, or 182
223		-	(B) the capital stock, membership interests or other equity interests of a 183
224		-	group practice by (i) another group practice that results in a group 184
225		-	practice comprised of eight or more physicians, or (ii) a hospital, 185
226		-	hospital system, captive professional entity, medical foundation or 186
227		-	other entity organized or controlled by such hospital or hospital system; 187
228		-	(3) the employment of all or substantially all of the physicians of a group 188
229		-	practice by (A) another group practice that results in a group practice 189
230		-	comprised of eight or more physicians, or (B) a hospital, hospital system, 190
231		-	captive professional entity, medical foundation or other entity 191
232		-	organized by, controlled by or otherwise affiliated with such hospital or 192
233		-	hospital system; and (4) the acquisition of one or more insolvent group 193
234		-	practices by (A) another group practice that results in a group practice 194
235		-	comprised of eight or more physicians, or (B) a hospital, hospital system, 195
236		-	captive professional entity, medical foundation or other entity 196
237		-	organized by, controlled by or otherwise affiliated with such hospital or 197
238		-	hospital system. 198
239		-	(d) (1) The written notice required under subsection (c) of this section 199
240		-	shall identify each party to the transaction and describe the material 200
241		-	change as of the date of such notice to the business or corporate structure 201
242		-	of the group practice, including: (A) A description of the nature of the 202
243		-	proposed relationship among the parties to the proposed transaction; 203
244		-	(B) the names and specialties of each physician that is a member of the 204 Substitute Bill No. 7224
	220	+	LCO No. 6159 7 of 12
	221	+
	222	+	that files merger, acquisition or any other information regarding market 160
	223	+	concentration with the Federal Trade Commission or the United States 161
	224	+	Department of Justice, in compliance with the Hart-Scott-Rodino 162
	225	+	Antitrust Improvements Act, 15 USC 18a, where a hospital, hospital 163
	226	+	system or other health care provider is a party to the merger or 164
	227	+	acquisition that is the subject of such information, such person shall 165
	228	+	provide written notification to the Attorney General of such filing and, 166
	229	+	upon the request of the Attorney General, provide a copy of such 167
	230	+	merger, acquisition or other information. 168
	231	+	(c) Not less than thirty days prior to the effective date of any 169
	232	+	transaction that results in a material change to the business or corporate 170
	233	+	structure of a group practice, the parties to the transaction shall submit 171
	234	+	written notice to the Attorney General of such material change. For 172
	235	+	purposes of this subsection, a material change to the business or 173
	236	+	corporate structure of a group practice includes: (1) The merger, 174
	237	+	consolidation or other affiliation of a group practice with (A) another 175
	238	+	group practice that results in a group practice comprised of eight or 176
	239	+	more physicians, or (B) a hospital, hospital system, captive professional 177
	240	+	entity, medical foundation or other entity organized or controlled by 178
	241	+	such hospital or hospital system; (2) the acquisition of all or 179
	242	+	substantially all of (A) the properties and assets of a group practice, or 180
	243	+	(B) the capital stock, membership interests or other equity interests of a 181
	244	+	group practice by (i) another group practice that results in a group 182
	245	+	practice comprised of eight or more physicians, or (ii) a hospital, 183
	246	+	hospital system, captive professional entity, medical foundation or 184
	247	+	other entity organized or controlled by such hospital or hospital system; 185
	248	+	(3) the employment of all or substantially all of the physicians of a group 186
	249	+	practice by (A) another group practice that results in a group practice 187
	250	+	comprised of eight or more physicians, or (B) a hospital, hospital system, 188
	251	+	captive professional entity, medical foundation or other entity 189
	252	+	organized by, controlled by or otherwise affiliated with such hospital or 190
	253	+	hospital system; and (4) the acquisition of one or more insolvent group 191
	254	+	practices by (A) another group practice that results in a group practice 192
	255	+	Raised Bill No. 7224
245	256
246	257
247		-	LCO 8 of 11
248	258
249		-	group practice that is the subject of the proposed transaction and who 205
250		-	will practice medicine with the resulting group practice, hospital, 206
251		-	hospital system, captive professional entity, medical foundation or 207
252		-	other entity organized by, controlled by, or otherwise affiliated with 208
253		-	such hospital or hospital system following the effective date of the 209
254		-	transaction; (C) the names of the business entities that are to provide 210
255		-	services following the effective date of the transaction; (D) the address 211
256		-	for each location where such services are to be provided; (E) a 212
257		-	description of the services to be provided at each such location; and (F) 213
258		-	the primary service area to be served by each such location. 214
259		-	(2) Not later than thirty days after the effective date of any transaction 215
260		-	described in subsection (c) of this section, the parties to the transaction 216
261		-	shall submit written notice to the Commissioner of Health Strategy. 217
262		-	Such written notice shall include, but need not be limited to, the same 218
263		-	information described in subdivision (1) of this subsection. The 219
264		-	commissioner shall post a link to such notice on the Office of Health 220
265		-	Strategy's Internet web site. 221
266		-	(e) Not less than thirty days prior to the effective date of any 222
267		-	transaction that results in an affiliation between one hospital or hospital 223
268		-	system and another hospital or hospital system, the parties to the 224
269		-	affiliation shall submit written notice to the Attorney General of such 225
270		-	affiliation. Such written notice shall identify each party to the affiliation 226
271		-	and describe the affiliation as of the date of such notice, including: (1) A 227
272		-	description of the nature of the proposed relationship among the parties 228
273		-	to the affiliation; (2) the names of the business entities that are to provide 229
274		-	services following the effective date of the affiliation; (3) the address for 230
275		-	each location where such services are to be provided; (4) a description 231
276		-	of the services to be provided at each such location; and (5) the primary 232
277		-	service area to be served by each such location. 233
278		-	(f) Not less than thirty days prior to the effective date of any 234
279		-	transaction that results in the lease of the main campus of a hospital 235
280		-	from a health care real estate investment trust, as defined in Section 856 236
281		-	of the Internal Revenue Code of 1986, or any subsequent corresponding 237 Substitute Bill No. 7224
	259	+	LCO No. 6159 8 of 12
	260	+
	261	+	comprised of eight or more physicians, or (B) a hospital, hospital system, 193
	262	+	captive professional entity, medical foundation or other entity 194
	263	+	organized by, controlled by or otherwise affiliated with such hospital or 195
	264	+	hospital system. 196
	265	+	(d) (1) The written notice required under subsection (c) of this section 197
	266	+	shall identify each party to the transaction and describe the material 198
	267	+	change as of the date of such notice to the business or corporate structure 199
	268	+	of the group practice, including: (A) A description of the nature of the 200
	269	+	proposed relationship among the parties to the proposed transaction; 201
	270	+	(B) the names and specialties of each physician that is a member of the 202
	271	+	group practice that is the subject of the proposed transaction and who 203
	272	+	will practice medicine with the resulting group practice, hospital, 204
	273	+	hospital system, captive professional entity, medical foundation or 205
	274	+	other entity organized by, controlled by, or otherwise affiliated with 206
	275	+	such hospital or hospital system following the effective date of the 207
	276	+	transaction; (C) the names of the business entities that are to provide 208
	277	+	services following the effective date of the transaction; (D) the address 209
	278	+	for each location where such services are to be provided; (E) a 210
	279	+	description of the services to be provided at each such location; and (F) 211
	280	+	the primary service area to be served by each such location. 212
	281	+	(2) Not later than thirty days after the effective date of any transaction 213
	282	+	described in subsection (c) of this section, the parties to the transaction 214
	283	+	shall submit written notice to the Commissioner of Health Strategy. 215
	284	+	Such written notice shall include, but need not be limited to, the same 216
	285	+	information described in subdivision (1) of this subsection. The 217
	286	+	commissioner shall post a link to such notice on the Office of Health 218
	287	+	Strategy's Internet web site. 219
	288	+	(e) Not less than thirty days prior to the effective date of any 220
	289	+	transaction that results in an affiliation between one hospital or hospital 221
	290	+	system and another hospital or hospital system, the parties to the 222
	291	+	affiliation shall submit written notice to the Attorney General of such 223
	292	+	affiliation. Such written notice shall identify each party to the affiliation 224
	293	+	Raised Bill No. 7224
282	294
283	295
284		-	LCO 9 of 11
285	296
286		-	internal revenue code of the United States, as amended from time to 238
287		-	time, the parties to the transaction shall submit written notice of such 239
288		-	proposed lease to the Attorney General and the Commissioner of Health 240
289		-	Strategy. 241
290		-	[(f)] (g) Written information submitted to the Attorney General 242
291		-	pursuant to subsections (b) to [(e)] (f), inclusive, of this section shall be 243
292		-	maintained and used by the Attorney General in the same manner as 244
293		-	provided in section 35-42. 245
294		-	[(g)] (h) Not later than January 15, 2018, and annually thereafter, each 246
295		-	hospital and hospital system shall file with the Attorney General and 247
296		-	the Commissioner of Health Strategy a written report describing the 248
297		-	activities of the group practices owned or affiliated with such hospital 249
298		-	or hospital system. Such report shall include, for each such group 250
299		-	practice: (1) A description of the nature of the relationship between the 251
300		-	hospital or hospital system and the group practice; (2) the names and 252
301		-	specialties of each physician practicing medicine with the group 253
302		-	practice; (3) the names of the business entities that provide services as 254
303		-	part of the group practice and the address for each location where such 255
304		-	services are provided; (4) a description of the services provided at each 256
305		-	such location; and (5) the primary service area served by each such 257
306		-	location. 258
307		-	[(h)] (i) Not later than January 15, 2018, and annually thereafter, each 259
308		-	group practice comprised of thirty or more physicians that is not the 260
309		-	subject of a report filed under subsection [(g)] (h) of this section shall file 261
310		-	with the Attorney General and the Commissioner of Health Strategy a 262
311		-	written report concerning the group practice. Such report shall include, 263
312		-	for each such group practice: (1) The names and specialties of each 264
313		-	physician practicing medicine with the group practice; (2) the names of 265
314		-	the business entities that provide services as part of the group practice 266
315		-	and the address for each location where such services are provided; (3) 267
316		-	a description of the services provided at each such location; and (4) the 268
317		-	primary service area served by each such location. 269 Substitute Bill No. 7224
	297	+	LCO No. 6159 9 of 12
	298	+
	299	+	and describe the affiliation as of the date of such notice, including: (1) A 225
	300	+	description of the nature of the proposed relationship among the parties 226
	301	+	to the affiliation; (2) the names of the business entities that are to provide 227
	302	+	services following the effective date of the affiliation; (3) the address for 228
	303	+	each location where such services are to be provided; (4) a description 229
	304	+	of the services to be provided at each such location; and (5) the primary 230
	305	+	service area to be served by each such location. 231
	306	+	(f) Not less than thirty days prior to the effective date of any 232
	307	+	transaction that results in the lease of the main campus of a hospital 233
	308	+	from a health care real estate investment trust, as defined in Section 856 234
	309	+	of the Internal Revenue Code of 1986, or any subsequent corresponding 235
	310	+	internal revenue code of the United States, as amended from time to 236
	311	+	time, the parties to the transaction shall submit written notice of such 237
	312	+	proposed lease to the Attorney General and the Commissioner of Health 238
	313	+	Strategy. 239
	314	+	[(f)] (g) Written information submitted to the Attorney General 240
	315	+	pursuant to subsections (b) to [(e)] (f), inclusive, of this section shall be 241
	316	+	maintained and used by the Attorney General in the same manner as 242
	317	+	provided in section 35-42. 243
	318	+	[(g)] (h) Not later than January 15, 2018, and annually thereafter, each 244
	319	+	hospital and hospital system shall file with the Attorney General and 245
	320	+	the Commissioner of Health Strategy a written report describing the 246
	321	+	activities of the group practices owned or affiliated with such hospital 247
	322	+	or hospital system. Such report shall include, for each such group 248
	323	+	practice: (1) A description of the nature of the relationship between the 249
	324	+	hospital or hospital system and the group practice; (2) the names and 250
	325	+	specialties of each physician practicing medicine with the group 251
	326	+	practice; (3) the names of the business entities that provide services as 252
	327	+	part of the group practice and the address for each location where such 253
	328	+	services are provided; (4) a description of the services provided at each 254
	329	+	such location; and (5) the primary service area served by each such 255
	330	+	location. 256
	331	+	Raised Bill No. 7224
318	332
319	333
320		-	LCO 10 of 11
321	334
322		-	[(i)] (j) Not later than January 15, 2018, and annually thereafter, each 270
323		-	hospital and hospital system shall file with the Attorney General and 271
324		-	the Commissioner of Health Strategy a written report describing each 272
325		-	affiliation with another hospital or hospital system. Such report shall 273
326		-	include: (1) The name and address of each party to the affiliation; (2) a 274
327		-	description of the nature of the relationship among the parties to the 275
328		-	affiliation; (3) the names of the business entities that provide services as 276
329		-	part of the affiliation and the address for each location where such 277
330		-	services are provided; (4) a description of the services provided at each 278
331		-	such location; and (5) the primary service area served by each such 279
332		-	location. 280
333		-	Sec. 4. Section 19a-486g of the general statutes is repealed and the 281
334		-	following is substituted in lieu thereof (Effective October 1, 2025): 282
335		-	(a) The Commissioner of Public Health shall refuse to issue a license 283
336		-	to, or if issued shall suspend or revoke the license of, a hospital if the 284
337		-	commissioner finds, after a hearing and opportunity to be heard, that: 285
338		-	(1) There was a transaction described in section 19a-486a that 286
339		-	occurred without the approval of the Commissioner of Health Strategy, 287
340		-	if such approval was required by sections 19a-486 to 19a-486h, inclusive; 288
341		-	(2) There was a transaction described in section 19a-486a without the 289
342		-	approval of the Attorney General, if such approval was required by 290
343		-	sections 19a-486 to 19a-486h, inclusive, and the Attorney General 291
344		-	certifies to the Commissioner of Health Strategy that such transaction 292
345		-	involved a material amount of the nonprofit hospital's assets or 293
346		-	operations or a change in control of operations; or 294
347		-	(3) The hospital is not complying with the terms of an agreement 295
348		-	approved by the Attorney General and Commissioner of Health 296
349		-	Strategy pursuant to sections 19a-486 to 19a-486h, inclusive. 297
350		-	(b) On and after October 1, 2025, the Commissioner of Public Health 298
351		-	shall refuse to issue a license to a hospital, or renew any such license, if 299
352		-	the commissioner finds, after a hearing and opportunity to be heard, 300 Substitute Bill No. 7224
	335	+	LCO No. 6159 10 of 12
	336	+
	337	+	[(h)] (i) Not later than January 15, 2018, and annually thereafter, each 257
	338	+	group practice comprised of thirty or more physicians that is not the 258
	339	+	subject of a report filed under subsection [(g)] (h) of this section shall file 259
	340	+	with the Attorney General and the Commissioner of Health Strategy a 260
	341	+	written report concerning the group practice. Such report shall include, 261
	342	+	for each such group practice: (1) The names and specialties of each 262
	343	+	physician practicing medicine with the group practice; (2) the names of 263
	344	+	the business entities that provide services as part of the group practice 264
	345	+	and the address for each location where such services are provided; (3) 265
	346	+	a description of the services provided at each such location; and (4) the 266
	347	+	primary service area served by each such location. 267
	348	+	[(i)] (j) Not later than January 15, 2018, and annually thereafter, each 268
	349	+	hospital and hospital system shall file with the Attorney General and 269
	350	+	the Commissioner of Health Strategy a written report describing each 270
	351	+	affiliation with another hospital or hospital system. Such report shall 271
	352	+	include: (1) The name and address of each party to the affiliation; (2) a 272
	353	+	description of the nature of the relationship among the parties to the 273
	354	+	affiliation; (3) the names of the business entities that provide services as 274
	355	+	part of the affiliation and the address for each location where such 275
	356	+	services are provided; (4) a description of the services provided at each 276
	357	+	such location; and (5) the primary service area served by each such 277
	358	+	location. 278
	359	+	Sec. 4. Section 19a-486g of the general statutes is repealed and the 279
	360	+	following is substituted in lieu thereof (Effective October 1, 2025): 280
	361	+	(a) The Commissioner of Public Health shall refuse to issue a license 281
	362	+	to, or if issued shall suspend or revoke the license of, a hospital if the 282
	363	+	commissioner finds, after a hearing and opportunity to be heard, that: 283
	364	+	(1) There was a transaction described in section 19a-486a that 284
	365	+	occurred without the approval of the Commissioner of Health Strategy, 285
	366	+	if such approval was required by sections 19a-486 to 19a-486h, inclusive; 286
	367	+	(2) There was a transaction described in section 19a-486a without the 287
	368	+	Raised Bill No. 7224
353	369
354	370
355		-	LCO 11 of 11
356	371
357		-	that the main campus of the hospital, as defined in section 19a-486i, as 301
358		-	amended by this act, is leased from a health care real estate investment 302
359		-	trust, as defined in Section 856 of the Internal Revenue Code of 1986, or 303
360		-	any subsequent corresponding internal revenue code of the United 304
361		-	States, as amended from time to time, unless such lease was entered into 305
362		-	prior to October 1, 2025. 306
	372	+	LCO No. 6159 11 of 12
	373	+
	374	+	approval of the Attorney General, if such approval was required by 288
	375	+	sections 19a-486 to 19a-486h, inclusive, and the Attorney General 289
	376	+	certifies to the Commissioner of Health Strategy that such transaction 290
	377	+	involved a material amount of the nonprofit hospital's assets or 291
	378	+	operations or a change in control of operations; or 292
	379	+	(3) The hospital is not complying with the terms of an agreement 293
	380	+	approved by the Attorney General and Commissioner of Health 294
	381	+	Strategy pursuant to sections 19a-486 to 19a-486h, inclusive. 295
	382	+	(b) On and after October 1, 2025, the Commissioner of Public Health 296
	383	+	shall refuse to issue a license to a hospital, or renew any such license, if 297
	384	+	the commissioner finds, after a hearing and opportunity to be heard, 298
	385	+	that the main campus of the hospital, as defined in section 19a-486i, as 299
	386	+	amended by this act, is leased from a health care real estate investment 300
	387	+	trust, as defined in Section 856 of the Internal Revenue Code of 1986, or 301
	388	+	any subsequent corresponding internal revenue code of the United 302
	389	+	States, as amended from time to time, unless such lease was entered into 303
	390	+	prior to October 1, 2025. 304
363	391		This act shall take effect as follows and shall amend the following
364	392		sections:
365	393
366	394		Section 1 October 1, 2025 4-274
367	395		Sec. 2 October 1, 2025 4-275
368	396		Sec. 3 October 1, 2025 19a-486i
369	397		Sec. 4 October 1, 2025 19a-486g
370	398
371		-	Statement of Legislative Commissioners:
372		-	Section 2(a)(9)(A) was redrafted for clarity and consistency with
373		-	Sections 1(3) and (7).
	399	+	Statement of Purpose:
	400	+	To impose liability on entities that have an ownership interest for
	401	+	violations of the False Claims Act and to prohibit granting a new license
	402	+	or certain renewal of a hospital license with a lease back arrangement
	403	+	for its main campus and require notification to the Attorney General of
	404	+	any such arrangement.
374	405
375		-	GAE Joint Favorable Subst. -LCO
	406	+	Raised Bill No. 7224
	407	+
	408	+
	409	+
	410	+	LCO No. 6159 12 of 12
	411	+
	412	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	413	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	414	+	underlined.]
376	415