The Vermont Statutes Online

Title 18 : Health

Chapter 233 : Clinical Decision Making

• § 9772. Limitations on control over clinical decision making by private equity group or hedge fund

  (a) The purpose of this section is to ensure that clinical decision making and treatment decisions are exclusively in the hands of health care providers and to safeguard against nonlicensed individuals or entities, such as private equity groups and hedge funds, exerting influence or control over health care delivery.

  (b) A private equity group or hedge fund involved in any manner with a health care facility doing business in this State, including as an investor in a health care facility or as an investor or owner of the assets of a health care facility, shall not do any of the following with respect to the health care facility:

  (1) interfere with the judgment of health care providers in making health care decisions, including any of the following:

  (A) determining which diagnostic tests are appropriate for a particular condition;

  (B) determining the need for referrals to or consultation with another health care provider;

  (C) determining the patient’s care plan, including the treatment options available to the patient; and

  (D) determining how many patients a health care provider shall see in any given period of time or how many hours a health care provider shall work; or

  (2) exercise control over, or be delegated the power to do, any of the following:

  (A) setting clinical standards or policies, including clinical staffing levels;

  (B) controlling or otherwise determining the content of patient medical records;

  (C) hiring or firing health care providers, clinical staff, or medical assistants, or any combination of these, based in whole or in part on clinical competency or proficiency;

  (D) setting the parameters under which a health care provider or health care facility shall enter into contractual relationships with third-party payers;

  (E) setting the prices, rates, or amounts the health care facility charges for a health care provider’s services;

  (F) setting the clinical competency or proficiency parameters under which a health care provider shall enter into contractual relationships with other health care providers for the delivery of health care services;

  (G) making decisions regarding the coding and billing of diagnoses and procedures for patient care services; and

  (H) selecting or approving the selection of medical equipment and medical supplies for the health care facility.

  (c) A private equity group or hedge fund, or an entity controlled directly in whole or in part by a private equity group or hedge fund, shall not enter into an agreement or arrangement with a health care facility doing business in this State if the agreement or arrangement would enable the person to interfere with the ability of health care providers to make health care decisions, as set forth in subdivision (b)(1) of this section, or to exercise control over or be delegated the powers set forth in subdivision (b)(2) of this section.

  (d)(1) The organizational form of a health care facility as a sole proprietorship, partnership, foundation, or corporate entity of any kind shall not affect the applicability of this section.

  (2) Nothing in this section shall be construed to prohibit an unlicensed individual or entity from providing nonclinical management, administrative, or business services to; assisting; or consulting with a health care facility doing business in this State with respect to the decisions and activities described in subdivision (b)(2) of this section, provided that a licensed health care provider retains the ultimate responsibility for or approval of those decisions and activities and the services provided do not constitute an exercise of de facto control over the administrative, business, or clinical operations of a health care facility in a manner that affects a health care provider’s clinical decision making or the nature or quality of the health care services that the health care facility delivers.

  (e) A health care provider who is aggrieved by the actions of a private equity group or hedge fund, or an entity controlled directly in whole or in part by a private equity group or hedge fund, in violation of this section may bring an action in Superior Court for appropriate equitable relief, actual damages, reasonable costs, and attorney’s fees. (Added 2025, No. 133 (Adj. Sess.), § 1, eff. July 1, 2026.)