H.R. 3262House118th Congress (2023-2025)In Committee

To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information.

Introduced May 11, 2023

AI-Generated Summary

Updated January 20, 2026 at 7:26 AM UTC

The bill amends title XI of the Social Security Act to require certain health‑care entities—such as hospitals, large physician‑owned practices, ambulatory surgical centers, and independent emergency departments—to report detailed ownership and financial information to the Department of Health and Human Services. The reports must be submitted annually, and the aggregated data will be posted publicly, increasing transparency for consumers and policymakers.

Key Provisions

  • Requires an initial report by Jan 1 2025 (or within 60 days of formation) and yearly updates from each specified entity covering mergers, acquisitions, ownership changes, and parent‑company details.
  • For entities that are or include a hospital, additional data must be reported, including business structure, debt‑to‑earnings ratio, debt amounts, real‑estate leases/purchases, and, for non‑profit hospitals, capital‑gains investments and taxes paid.
  • The Secretary must post an annual summary on a publicly available HHS website starting Jan 1 2027, showing numbers of reporting entities, ownership changes, tax‑status changes, and trends in consolidation.
  • The Secretary will conduct random‑sample audits each year to verify compliance and accuracy of the submitted information.
  • Entities that fail to report or submit false information can be fined up to $5 million per violation.
  • Specifies that the Paperwork Reduction Act does not apply to the information collection under this section.

Legislative Activity

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3 earlier actions
HouseCommittee Latest Action

Referred to the Subcommittee on Health.

December 17, 2024

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HouseIntro Referral

Introduced in House

May 11, 2023

HouseIntro Referral

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

May 11, 2023

HouseCommittee

Referred to the Subcommittee on Health.

May 12, 2023

HouseCommittee

Referred to the Subcommittee on Health.

December 17, 2024

Bill Text

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Introduced in HouseIssued May 11, 2023

I

118th CONGRESS

1st Session

H. R. 3262

IN THE HOUSE OF REPRESENTATIVES

May 11, 2023

Ms. Schakowsky (for herself and Mr. Bilirakis) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information.

1.

Mandatory reporting with respect to certain health-related ownership information

Part A of title XI of the Social Security Act (42 U.S.C. 1301 et seq.) is amended by adding at the end the following new section:

1150D.

Mandatory reporting with respect to certain health-related ownership information

(a)

Mandatory reporting with respect certain health-Related ownership information

(1)

Initial report

Not later than January 1, 2025 (or in the case of a specified entity formed after January 1, 2025, within 60 days of becoming a specified entity), each specified entity (as defined in subsection (f)(5)) shall submit to the Secretary, in a form and manner specified by the Secretary, a report containing the following information:

(A)

Data on mergers, acquisitions, and changes in ownership with respect to such specified entity for the previous 1-year period.

(B)

In the case that a specified entity is, or includes, a hospital, the additional information described in subsection (b).

(C)

As applicable, the name, address, and business structure of the parent company of such specified entity (including the tax status of such parent company), as of the date of the submission of this report.

(D)

Any other information with respect to ownership of a specified entity, as determined by the Secretary.

(2)

Subsequent reports

Not later than 1 year after submitting the report under paragraph (1), and annually thereafter, each specified entity shall submit to the Secretary an updated report, including—

(A)
(i)

data on mergers, acquisitions, and changes in ownership with respect to such entities for the previous 1-year period; and

(ii)

any other information with respect to ownership of a specified entity, as determined by the Secretary; and

(B)

in the case that a specified entity is, or includes, a hospital, the additional information described in subsection (b).

(b)

Additional information submitted by certain specified entities

For purposes of paragraphs (1)(B) and (2)(B) of subsection (a), with respect to a specified entity that is, or includes, a hospital, the information described in this subsection is the following information with respect to the previous 1-year period:

(1)

The business structure of the specified entity, including the business type and the tax status of such entity.

(2)

The average debt-to-earnings ratio of the specified entity.

(3)

The average amount of debt incurred—

(A)

by the hospital; and

(B)

by the entire specified entity.

(4)

Information with respect to real estate leases and purchases for property used, or intended to be used, to furnish or otherwise support the provision of health care services.

(5)

In the case of a non-profit hospital, a subsidiary of a non-profit hospital, or a 501(c)(3) entity that shares common ownership with a non-profit hospital, capital gains investments (disaggregated by the type of investment) and any taxes paid on such gains from such investments.

(6)

As applicable, information with respect to the parent company of such specified entity.

(c)

Public reporting

Not later than January 1, 2027, and annually thereafter, the Secretary shall post on a publicly available website of the Department of Health and Human Services a report with respect to the previous 1-year period, including—

(1)

the number of specified entities reporting for such year, disaggregated by the business structure of each specified entity;

(2)

the number of owners of each specified entity;

(3)

any change in ownership for each specified entity;

(4)

any change in the tax status of a specified entity;

(5)

an analysis of trends in horizontal and vertical consolidation, disaggregated by business structure and provider type; and

(6)

as applicable, the name, address, and business structure of the parent company of such specified entity (including the business type and the tax status of such parent company).

(d)

Audits

The Secretary shall conduct an annual audit consisting of a random sample of specified entities to verify compliance with the requirements of this section and the accuracy of information submitted pursuant to this section.

(e)

Penalty for failure To report

If a specified entity fails to provide a complete report under subsection (a), or submits a report containing false information, such entity shall be subject to a civil monetary penalty of not more than $5,000,000 for each such report not provided or containing false information. Such penalty shall be imposed and collected in the same manner as civil money penalties under subsection (a) of section 1128A are imposed and collected under that section.

(f)

Inapplicability of Paperwork Reduction Act

Chapter 35 of title 44, United States Code, shall not apply to collections of information made under this section.

(g)

Definitions

In this section:

(1)

Health plan

The term health plan has the meaning given such term in section 1128C(c).

(2)

Hospital

The term hospital has the meaning given such term in section 1861(e).

(3)

Independent freestanding emergency department

The term independent freestanding emergency department has the meaning given such term in section 2799A–1(a)(3)(D) of the Public Health Service Act.

(4)

Private equity company

The term private equity company means a publicly traded or non-publicly traded company that collects capital investments from individuals or entities and purchases an ownership share of a provider of services (as defined in section 1861(u)).

(5)

Specified entity

The term specified entity means—

(A)

a hospital;

(B)

a physician-owned physician practice with more than 25 physicians for a year;

(C)

a physician practice owned by a hospital, a health plan, a private equity company, or a venture capital firm;

(D)

an ambulatory surgical center meeting the standards specified under section 1832(a)(2)(F)(i); or

(E)

an independent freestanding emergency department.

(6)

Venture capital fund

The term venture capital fund has the meaning given such term in section 275.203(l)–1of title 17, Code of Federal Regulations.

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