HB 605 Alabama House · 2026 Regular Session

State Health Planning and Development Agency; Rural Health Antitrust Immunity Act created, collaboration among rural health care providers authorized; certification and supervision framework established, limited immunity from state and federal antitrust laws provided

This bill creates a new Rural Health Antitrust Immunity Act within the State Health Planning and Development Agency to allow rural healthcare providers to collaborate without fear of antitrust violations. It specifically prohibits the Agency from approving joint negotiations between rural healthcare providers and health insurers, employee welfare plans, or government reimbursement programs as allowed activities. The legislation establishes a certification and supervision framework for these collaborations while providing limited immunity from both state and federal antitrust laws. This policy change directly affects rural healthcare providers seeking to work together on negotiations and care delivery, aiming to support rural health infrastructure through authorized cooperation.

Issues: ✓ Healthcare

Bill status signed all 5 stages cleared

Introduction

Mar 2026

Committee Review

Apr 2026

House Passage

Mar 2026

Senate Passage

Apr 2026

Signed into Law

Apr 2026

Introduced Mar 10, 2026 Signed Apr 16, 2026

Maddy AI version diff · 2 comparisons

What changed between versions

Engrossed → Enrolled · 5 edits · Apr 16, 2026

MODERATE

The bill was finalized for signing (Enrolled) and includes significant policy updates to address rural healthcare challenges. Key changes involve expanding the list of allowed collaborative activities to include service line development and shared infrastructure, while explicitly prohibiting payers (like insurance companies) from participating in these collaborations. The text also adds a new finding that rural facilities are closing due to rising costs and workforce shortages, and clarifies the state's policy to replace competition with regulated collaboration where necessary.

Scope change

The bill's scope was expanded to explicitly allow 'Coordinated service line development' and 'Shared facilities, equipment, and infrastructure' as approved activities. Additionally, the scope of prohibited participants was clarified to strictly exclude health insurers and benefit plan administrators from participating in the approved collaborations.

SCOPE

Added 'Coordinated service line development' and 'Shared facilities, equipment, and infrastructure' to the list of activities rural providers can legally collaborate on.

ELIGIBILITY

Revised the findings section to state that rural facilities are closing due to increasing costs and workforce issues, replacing previous reasons like declining populations.

REQUIREMENT

Added a specific prohibition preventing health insurers, benefit plans, and their administrators from participating in or approving the rural healthcare collaborations.

Added a requirement for applicants to certify that their proposed collaboration is in 'good faith' and 'reasonably necessary' to advance the state's rural health policy.

TECHNICAL

Updated the bill header from 'Engrossed' to 'Enrolled' and adjusted the document tracking number from AR46WQ7-2 to AR46WQ7-3.

Floor votes

How they voted

This bill passed the Senate by voice vote (no roll call recorded).

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

Apr 9, 2026

Lower · Passed

Kiel motion to Concur In and Adopt Senate Amendment - Adopted Roll Call 1358

lower

Apr 9, 2026

Upper · Passed

Motion to Read a Third Time and Pass as Amended - Adopted Roll Call 1317

upper

Apr 9, 2026

Upper · Passed

Chesteen motion to Adopt - Adopted Roll Call 1316

upper

Apr 9, 2026

Introduced

Chesteen 1st Amendment Offered

upper

Apr 1, 2026

Upper · Passed

Reported Out of Committee Second House

upper

Mar 31, 2026

Upper · Passed

Pending Committee Action in Second House (Healthcare)

upper

Mar 31, 2026

Lower · Passed

Motion to Read a Third Time and Pass as Amended - Adopted Roll Call 1102

lower

Mar 31, 2026

Lower · Passed

Motion to Adopt - Adopted Roll Call 1101

lower

Mar 31, 2026

Introduced

Kiel 1st Amendment Offered

lower

Mar 18, 2026

Lower · Passed

Reported Out of Committee House of Origin

lower

Mar 10, 2026

Lower · Passed

Pending Committee Action in House of Origin (Judiciary)

lower

1 primary · 0 co-sponsors