What the bill does not do
It does not ban management companies
A practice can still hire an outside company for billing, payroll, offices, and computers. The company just cannot run the practice.
It does not ban outside money
Investors can still lend to practices, lease them buildings and equipment, and sell them services at a fair price. They cannot own the practice or skim its profits.
It does not touch how hospitals employ doctors today
Nonprofit health corporations, rural and critical-access hospitals, hospital districts, and medical schools keep the employment rights they already have.
It does not tell doctor-owned groups how to pay their doctors
A group owned entirely by physicians can use productivity pay if its physicians choose to.
It does not take effect overnight
New arrangements comply September 1, 2027; existing management deals by September 1, 2030; existing hospital coverage contracts by September 1, 2029 or next renewal; sitting medical directors by September 1, 2028.
It does not touch NP or PA licenses or scope
It only says the decision to use them in place of a physician belongs to physicians, not to a budget office.
It does not cap executive pay
Hospitals can still pay executives bonuses for safety, quality, patient experience, and the hospital’s overall finances. They just can’t reward squeezing doctors or patient volume, and the plan has to win the medical staff’s vote (Sec. 166.356). The doctors approve the bonus plan; they do not run the hospital or set salaries.
It does not hand the hospital to the doctors
The medical staff vote covers one thing only: the executive bonus plan. The board still runs budgets, hiring, base salaries, and operations (Sec. 166.356(d)).
It does not end real peer review
Hospitals can still act on a doctor’s competence or conduct. The action has to be documented and recommended by physicians in the same specialty after a fair hearing (Sec. 166.059).