The General Assembly Raised Bill No. 1452, effective October 1, 2025, introduces new regulations aimed at improving the working conditions and job security of hospital-affiliated physicians. The bill stipulates that hospitals cannot assign an attending physician more than eighteen patients during a twelve-hour shift unless the physician is compensated at a rate of one and one-half times their hourly rate or based on a relative value unit payment methodology, whichever is greater. It also mandates that health systems consult with physician members of a group practice before making staffing changes, with an independent monitor appointed if this requirement is not met. Significant staffing changes, defined as a fifty percent or more increase, reduction, or reassignment of a large group's workforce, must be communicated to the affected group practice and the Commissioner of Health Strategy at least 180 days in advance for review and approval.

Additionally, the bill enhances employment protections for physicians by prohibiting institutions from terminating a physician without just cause, which is defined strictly based on performance or conduct. Any employment contract allowing for at-will termination entered into after the effective date will be rendered void. The Commissioner of Health Strategy is also empowered to adopt regulations to ensure the effective enforcement of these provisions. Overall, Raised Bill No. 1452 aims to bolster the rights and job security of hospital-affiliated physicians, thereby contributing to a more stable healthcare workforce.