The proposed bill introduces the "Rhode Island Healthcare Transaction Oversight Act," which aims to enhance oversight of material change transactions involving healthcare entities in the state. Under this act, healthcare entities must submit written notice to the Rhode Island attorney general and the department of health at least 180 days prior to any material change transaction. This includes corporate mergers, acquisitions, changes in control, affiliations, joint ventures, real estate transactions involving material assets, or the closure of a healthcare facility.

The notice must include all material documents and information necessary for review, such as transaction agreements, organizational charts, financial statements, service plans, and prior transaction history. The attorney general and the department of health will publish a summary of the proposed transaction on publicly accessible websites within ten days of accepting a complete notice.

Following the submission, the attorney general and the department of health will conduct a preliminary review within 30 days to either approve the transaction, approve it with conditions, or designate it for a comprehensive review if it is likely to significantly affect competition, prices, quality, access, workforce, or health equity in the Rhode Island healthcare market.

If designated for comprehensive review, the attorney general and the department of health will conduct public hearings and complete a cost and market impact review (CMIR) within 90 days. The CMIR will examine various factors, including market share, price trends, access to services, quality of care, and the impact on underserved populations. The parties involved in the transaction will bear the burden of demonstrating that the transaction will not harm competition or access to care.

After the CMIR, the attorney general and the department of health may approve the transaction, approve it with conditions, or disapprove it. Conditions may include requirements related to pricing, maintenance of essential services, and workforce protections. A written determination will be issued no later than 60 days following the completion of the CMIR.

The act also allows for ongoing monitoring of approved transactions and the imposition of additional conditions if noncompliance or changed circumstances are found. Furthermore, the attorney general and the department of health may require reimbursement for the costs of review from the transaction parties. Failure to comply with the requirements of this chapter may result in civil penalties of $10,000 per day, in addition to any other legal remedies available.