An Act to Implement Certain Recommendations Related to the
Maine Legislature, Session 132, LD 2198
Committee: Health Coverage, Insurance and Financial Services
Amends: 22 MRSA §1730-B

Legislative Document
No. 2198
H.P. 1477
House of Representatives, February 10, 2026
An Act to Implement Certain Recommendations Related to the 
Ratio of Debt to Equity in Transactions Involving Health Care 
Entities from the Commission to Evaluate the Scope of Regulatory 
Review and Oversight over Health Care Transactions That Impact 
the Delivery of Health Care Services in the State
Reported by Representative MATHIESON of Kittery for the Joint Standing Committee on 
Health Coverage, Insurance and Financial Services pursuant to Resolve 2025, chapter 106, 
section 8.
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed pursuant to Joint Rule 218.
ROBERT B. HUNT
Clerk
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §1730-B is enacted to read:
§1730-B.  Limit on debt-to-equity ratio in transactions with health care entities 
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings.
A. "Health care entity" means a health care provider, a health care facility or a provider 
organization.  "Health care entity" does not include a nursing facility as defined in 
section 328, subsection 18. 
B.  "Health care facility" means a licensed institution providing health care services or 
a health care setting, including, but not limited to, hospitals and other licensed inpatient 
facilities; health systems consisting of one or more health care entities that are jointly 
owned or managed; ambulatory surgical or treatment centers; residential treatment 
centers; diagnostic, laboratory and imaging centers; freestanding emergency facilities; 
outpatient clinics; and rehabilitation and other therapeutic health settings.
C. "Health care provider" means a person, corporation, partnership, governmental unit, 
state institution, medical practice or other entity qualified or licensed under state law 
to perform or provide health care services to persons in the State. 
D. "Provider organization" means any corporation, partnership, business trust, 
association or organized group of persons that is in the business of health care delivery 
or management, whether incorporated or not, that represents one or more health care 
providers in contracting with carriers for the payment of health care services.  "Provider 
organization" includes, but is not limited to, physician organizations, physician-
hospital organizations, independent practice associations, health care provider 
networks, accountable care organizations and management services organizations and 
any other organization that contracts with carriers for payment for health care services. 
2. Debt-to-equity ratio. A person may not enter into any transaction with a health care 
entity in the State in which the ratio of debt to equity for the health care entity exceeds 
50%.
SUMMARY
This bill is reported out by the Joint Standing Committee on Health Coverage, 
Insurance and Financial Services pursuant to Resolve 2025, chapter 106 to implement a 
recommendation from the Commission to Evaluate the Scope of Regulatory Review and 
Oversight over Health Care Transactions That Impact the Delivery of Health Care Services 
in the State.  The joint standing committee has not taken a position on the substance of this 
bill. By reporting this bill out, the joint standing committee is not suggesting and does not 
intend to suggest that it agrees or disagrees with any aspect of this bill; instead, the joint 
standing committee is reporting the bill out for the sole purpose of having a bill printed that 
can be referred to a joint standing committee for an appropriate public hearing and 
subsequent processing in the normal course. The joint standing committee is taking this 
action to ensure clarity and transparency in the legislative review of the proposals contained 
in the bill.
This bill prohibits any transaction involving a health care entity in which the ratio of 
debt to equity is greater than 50%.