HB 2548 Washington House · 2025-2026 Regular Session

Strengthening health care market standards.

HB 2548 amends Washington state law to require 60-day advance notice to the Attorney General for significant healthcare entity transactions. It directly affects hospitals, hospital systems, and provider organizations (like physician groups or accountable care organizations) when they plan mergers, acquisitions, or changes in ownership structure. The bill mandates this notice for transactions involving entities generating $10 million+ in Washington patient revenue, or for conversions from nonprofit to for-profit status. This procedural requirement aims to increase transparency before major market shifts, without altering healthcare coverage or costs. The bill is currently pending in committee after failing to pass in the House.

Issues: ✓ Healthcare

Bill status signed all 5 stages cleared

Introduction

Jan 2026

Committee Review

Mar 2026

House Passage

Mar 2026

Senate Passage

Mar 2026

Signed into Law

Mar 2026

Introduced Jan 16, 2026 Signed Mar 25, 2026

Maddy AI version diff · 3 comparisons

What changed between versions

Engrossed Substitute Bill → Substitute Passed Legislature · 2 edits

MINOR

The bill was amended to exempt state-owned entities and public hospital districts from filing fees when entering contracting affiliations with each other. Additionally, the fee structure for other transactions was updated to include an exception clause and renumbered to accommodate this new exemption.

Scope change

The bill's applicability now excludes specific state and public hospital district contracting affiliations from the mandatory filing fee requirement.

ELIGIBILITY

Added an exemption for contracting affiliations between state-owned entities and public hospital districts, removing the filing fee requirement for these specific parties.

FISCAL

Updated the attorney general's fee assessment section to include the new exception and renumbered subsequent subsections accordingly.

Substitute Bill → Engrossed Substitute Bill · 7 edits · Mar 11, 2026

MODERATE

This bill updates the rules for reporting hospital and healthcare provider transactions to the Washington State Attorney General. The changes lower the revenue threshold for mandatory reporting, clarify what counts as a 'material change' to include majority ownership shifts, and streamline the filing fee structure and notice requirements.

Scope change

The bill expands the scope of transactions requiring notification by lowering the revenue threshold for out-of-state entities from $10 million to $10,000 and redefining 'control' to include majority ownership rather than a fixed 25% threshold.

ELIGIBILITY

The revenue threshold for triggering mandatory reporting for out-of-state entities was lowered from $10,000,000 to $10,000, significantly increasing the number of transactions subject to review.

DEFINITION

The definition of 'control' was simplified to include any majority ownership or controlling interest, removing the previous specific 25% ownership requirement.

REQUIREMENT

The definition of a 'material change' was updated to specifically include transactions resulting in a change of 'majority' ownership or control, rather than just any change in ownership.

Filing fees are now capped at one fee per transaction regardless of how many parties are involved, and the fee schedule remains based on the anticipated value of the deal.

The public notice of pending and completed transactions now explicitly lists the specific subsections of the reporting form that must be included in the public record.

TIMELINE

The timeline for submitting proof of transaction completion was clarified to require submission within 30 days of the transaction's actual completion, whether it was finalized, blocked by a court, or abandoned.

ENFORCEMENT

The waiting period for transactions under review was adjusted to allow it to extend if the Attorney General requests additional information, provided the parties certify they are in substantial compliance.

Bill → Substitute Bill · 7 edits

MODERATE

The bill was amended to reflect its progression through the legislative process, including updated sponsorship credits and a revised reading date. Substantively, the bill expanded its scope by adding two new RCW sections to be amended, clarifying the definition of 'control' to include specific ownership and voting thresholds, and establishing a tiered filing fee schedule for transactions involving health care entities. It also added new requirements for the attorney general to publicly report pending transactions and notified the secretary of state when nonprofit designations are at risk due to material changes.

Scope change

The bill's scope was expanded to include amendments to RCW 19.390.040 and 19.390.070, which were not present in the original version. The applicability of the filing fee requirements and public reporting mandates now applies more broadly to the transaction reporting process.

TECHNICAL

Updated bill header to reflect the new bill number (H-3367.1) and substituted title, along with changing the reading date to 02/04/26 and adding committee referral credit.

REQUIREMENT

Expanded the list of RCWs to be amended to include 19.390.040 and 19.390.070, broadening the legislative changes related to transaction reporting and confidentiality.

Added a new requirement for the attorney general to publish a quarterly list of pending and completed transactions on their website.

Added a new requirement for the attorney general to notify the secretary of state when a transaction involving a material change includes a nonprofit corporation.

Clarified that 'Contracting affiliation' now explicitly includes 'health care services' in the description of services being negotiated.

DEFINITION

Added a new definition for 'Affiliated with' and renumbered the definition of 'Control' to explicitly list four specific criteria (25% ownership, 25% capital/profit interest, 25% board election power, or 25% management influence).

FISCAL

Established a specific tiered fee schedule for filing transaction notices, ranging from $2,500 for small transactions up to $25,000 for transactions over $20 million.

Floor votes · Senate Mar 5, 2026 · House Feb 16, 2026

How they voted

32–19

Passed

Total votes 51

Mar 5, 2026

D Democratic31

31 Yea

100% Yea

R Republican20

1 Yea 19 Nay

95% Nay

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Mar 25, 2026

Signed into law

Governor signed.

executive

Mar 12, 2026

Upper · Passed

President signed.

upper

Mar 11, 2026

Lower · Passed

Speaker signed.

lower

Mar 11, 2026

Lower · Passed

Passed final passage; yeas, 55; nays, 41; absent, 0; excused, 2.

lower

Mar 11, 2026

Lower · Passed

House concurred in Senate amendments.

lower

Mar 5, 2026

Upper · Passed

Committee amendment(s) adopted with no other amendments.

upper

Mar 5, 2026

Senate · Passed

Senate Vote: pass (32-19)

senate

Feb 25, 2026

Committee

On motion, referred to Rules Committee for second reading.

upper

Feb 24, 2026

Upper · Passed

Minority; without recommendation.

upper

Feb 24, 2026

Upper · Passed

Minority; do not pass.

upper

Feb 24, 2026

Committee

And refer to Ways & Means.

upper

Feb 24, 2026

Upper · Passed

LAW - Majority; do pass with amendment(s).

upper

Feb 24, 2026

Upper · Passed

Executive action taken in the Senate Committee on Law & Justice at 8:00 AM.

upper

Feb 20, 2026

Upper · Passed

Public hearing in the Senate Committee on Law & Justice at 2:00 PM.

upper

Feb 16, 2026

Lower · Passed

Floor amendment(s) adopted.

lower

Feb 9, 2026

Committee

Referred to Rules 2 Review.

lower

Feb 9, 2026

Lower · Passed

Minority; do not pass.

lower

Feb 9, 2026

Lower · Passed

APP - Majority; do pass 1st substitute bill proposed by Civil Rights & Judiciary.

lower

Feb 9, 2026

Lower · Passed

Executive action taken in the House Committee on Appropriations at 10:30 AM.

lower

Feb 6, 2026

Lower · Passed

Public hearing in the House Committee on Appropriations at 10:30 AM.

lower

Feb 4, 2026

Committee

Referred to Appropriations.

lower

Feb 3, 2026

Lower · Passed

Minority; without recommendation.

lower

Feb 3, 2026

Lower · Passed

Minority; do not pass.

lower

Feb 3, 2026

Lower · Passed

Executive action taken in the House Committee on Civil Rights & Judiciary at 10:30 AM.

lower

Jan 21, 2026

Lower · Passed

Public hearing in the House Committee on Civil Rights & Judiciary at 8:00 AM.

lower

1 primary · 5 co-sponsors