Take Back Our Hospitals Act of 2026
Summary
What This Bill Does
The Take Back Our Hospitals Act prohibits Medicare payment to a hospital or skilled nursing facility owned or controlled by a covered firm or one of its affiliates. Covered firms include private equity funds, corporations owned or controlled by private equity funds, and real estate investment trusts.
A facility already under covered ownership on enactment receives three years before the payment prohibition treats it as violating the rule. A facility found in violation is entitled to reasonable notice and an opportunity for a hearing under existing federal exclusion procedures.
A covered firm or affiliate that owns, controls, or is affiliated with a violating facility is jointly and severally liable for the facility's penalties and obligations. Control includes direct or indirect power over management, administration, assets, or policy through voting securities, management contracts, or similar means determined by HHS. Holding at least 10 percent of voting securities is deemed control. Ordinary contracts for goods or non-management services are excluded from the contract-based control language.
The bill conditions Medicare payment; it does not directly ban ownership under all law, govern Medicaid payment, or require immediate divestiture on enactment. Covered owners can leave the ownership or control position during the transition, and affected facilities retain notice and hearing rights.
Who Benefits and How
Medicare beneficiaries may gain protection from ownership structures Congress associates with financial extraction or care risk. Independently owned hospitals and skilled nursing facilities gain a competitive advantage in Medicare participation. Clinicians and facility staff may face less pressure from covered ownership if facilities divest. Medicare oversight officials gain a clear ownership-based payment rule and recourse against owners for unpaid penalties.
Who Bears the Burden and How
Private equity funds, private-equity-controlled companies, real estate investment trusts, and affiliates must divest, relinquish control, or accept loss of Medicare payment after the transition. Affected hospitals and nursing facilities risk substantial revenue loss and must document ownership and control. Investors and management contractors face a broad 10-percent and indirect-control test plus joint liability. CMS must identify covered relationships, provide hearings, stop payment, and pursue obligations. Communities may face access risk if an affected facility closes instead of restructuring.
Key Provisions
- Bars Medicare payment to facilities under covered ownership or control.
- Covers private equity funds, controlled corporations, and REITs.
- Extends the rule to affiliates.
- Gives facilities already covered at enactment a three-year transition.
- Provides reasonable notice and an opportunity for a hearing.
- Makes covered owners and affiliates jointly liable for obligations.
- Deems ownership of 10 percent of voting securities to be control.
- Excludes ordinary goods and non-management contracts from contract control.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Prohibits Medicare payment to hospitals and skilled nursing facilities owned or controlled by private equity funds, private-equity-controlled corporations, real estate investment trusts, or their affiliates, with a three-year transition for existing ownership, hearing rights, and joint liability for covered owners and affiliates.
Key Policy Areas
Medicare Provider Participation, Hospital Ownership, Skilled Nursing Facilities, Private Equity in Health Care, Health-Care Corporate Liability
Primary Purpose
Prohibits Medicare payment to hospitals and skilled nursing facilities owned or controlled by private equity funds, private-equity-controlled corporations, real estate investment trusts, or their affiliates, with a three-year transition for existing ownership, hearing rights, and joint liability for covered owners and affiliates.
Policy Domains
Section 2 Medicare payment prohibition for covered ownership
Identified Gains
- Medicare patients in affected facilities
- Independent hospitals competing for Medicare patients
- Independent nursing facilities competing for patients
- Clinicians working after covered-owner divestiture
- CMS enforcement teams collecting owner liabilities
- Communities retaining restructured facilities
Identified Costs
- Private equity funds owning hospitals
- Real estate investment trusts owning facilities
- Private-equity-controlled hospital corporations
- Affiliates jointly liable for facility penalties
- Hospitals losing Medicare payment eligibility
- Skilled nursing facilities losing Medicare payments
- CMS ownership-review staff
- Patients exposed to facility closure risk
Sponsors
Legislative Progress
In CommitteeReferred to the Committee on Ways and Means, and in …
Introduced in House
Ms. Scanlon (for herself, Ms. DeLauro, Mr. Deluzio, Ms. Jayapal, …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Hospitals losing Medicare payment eligibility, Independent hospitals competing for Medicare patients, Private-equity-controlled hospital corporations
Positive-direction: Independent hospitals competing for Medicare patients
Negative-direction: Hospitals losing Medicare payment eligibility, Private-equity-controlled hospital corporations
Medicare patients in affected facilities, Patients exposed to facility closure risk
Positive-direction: Medicare patients in affected facilities
Negative-direction: Patients exposed to facility closure risk
Independent nursing facilities competing for patients, Skilled nursing facilities losing Medicare payments
Positive-direction: Independent nursing facilities competing for patients
Negative-direction: Skilled nursing facilities losing Medicare payments
CMS enforcement teams collecting owner liabilities, CMS ownership-review staff
Positive-direction: CMS enforcement teams collecting owner liabilities
Negative-direction: CMS ownership-review staff
Affiliates jointly liable for facility penalties, Private equity funds owning hospitals
Clinicians working after covered-owner divestiture
Communities retaining restructured facilities
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "affiliate"
- → Entity controlling or under common control with a covered firm
- "beneficiary"
- → Medicare beneficiary receiving facility care
- "administrator"
- → Secretary of Health and Human Services acting through CMS
- "covered_owner"
- → Private equity fund or real estate investment trust
- "prohibited_provider"
- → Hospital or skilled nursing facility under covered ownership
Note: {'scope_ids': ['covered_firm_medicare_payment_ban'], 'description': 'The provision is a Medicare payment condition rather than a universal ownership ban; existing covered facilities receive three years, affected providers retain notice and hearing rights, and ordinary goods or non-management contracts do not alone establish control.'}
Key Definitions
Terms defined in this bill
Direct or indirect power over management, administrative functions, assets, or policies, including at least 10 percent of voting securities or qualifying management contracts.
An entity that controls, is controlled by, or is under common control with another entity.
A private equity fund, a corporation owned or controlled by a private equity fund, or a real estate investment trust.
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology