H.R. 7537

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7537 Introduced in House (IH)]

<DOC>

119th CONGRESS
2d Session
H. R. 7537

To prevent exploitative private equity practices, and for other 
purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

February 12, 2026

Ms. Goodlander introduced the following bill; which was referred to the 
Committee on Ways and Means, and in addition to the Committees on the 
Judiciary, and Energy and Commerce, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

A BILL

To prevent exploitative private equity practices, and for other 
purposes.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Corporate Crimes Against Health Care 
Act''.

SEC. 2. UNJUST ENRICHMENT CLAWBACK AUTHORITY AND CRIMINAL PENALTY.

(a) Unjust Enrichment Clawback.--Chapter 31 of title 18, United 
States Code, is amended by adding at the end the following:
``Sec. 671. Unjust enrichment clawback and criminal penalty
``(a) Prohibited Conduct.--Any covered party whose actions 
contributed to a triggering event that results in the death or injury 
of a patient or patients under the care of the target firm, shall be 
punished in accordance with sections 672 and 673.
``Sec. 672. Criminal penalty
``Whoever violates section 671 shall be imprisoned for not less 
than 1 year or greater than 6 years.
``Sec. 673. Civil penalty
``(a) Amount of Penalty.--Whoever violates section 671 shall be 
subject to a civil penalty in an amount of not more than 5 times the 
amount of any clawback authorized under section 674.
``(b) Deposit.--Any amount of civil penalty collected under this 
section shall be deposited as miscellaneous receipts in the Treasury of 
the United States.
``Sec. 674. Clawback
``(a) In General.--
``(1) Prohibition.--It shall be unlawful for any covered 
party to acquire from a target firm covered compensation by 
unjust enrichment, and any such covered party shall be subject 
to the penalties described in sections 672 and 673 in addition 
to the required clawbacks under this section.
``(2) Penalty.--
``(A) Required clawbacks.--If a target firm 
experiences a triggering event, the Attorney General or 
a State attorney general may claw back all or part of 
the covered compensation received by the covered party 
that is obtained from the target firm during the 
preceding or succeeding 10 years.
``(B) Actions to recover required clawbacks.--
``(i) Powers of the attorney general.--
``(I) In general.--Except as 
provided in clause (ii), the Attorney 
General may enforce this section.
``(II) Authority preserved.--
Nothing in this section shall be 
construed to limit the authority of the 
Attorney General under any provision of 
law.
``(III) Penalty.--In an action 
brought by the Attorney General to 
enforce this section and the 
regulations promulgated under this 
section, a covered party shall be 
liable for all or part of the covered 
compensation received by the covered 
party that is obtained from the target 
firm during the preceding or succeeding 
10 years.
``(ii) Enforcement by state attorneys 
general.--
``(I) Civil action.--If an attorney 
general of a State has reason to 
believe that a triggering event has 
harmed the residents of that State, the 
attorney general of the State may, as 
parens patriae, bring a civil action on 
behalf of the residents of the State in 
an appropriate district court of the 
United States to recover all or part of 
the covered compensation received by 
the covered party that is obtained from 
the target firm during the preceding or 
succeeding 10 years.
``(II) Rights of the attorney 
general.--
``(aa) Notice to attorney 
general.--

``(AA) In 
general.--Except as 
provided in subitem 
(CC), the attorney 
general of a State 
shall notify the 
Attorney General in 
writing that the 
attorney general of the 
State intends to bring 
a civil action under 
subclause (I) not later 
than 10 days before 
initiating the civil 
action.

``(BB) Contents.--
The notification 
required under subitem 
(AA) with respect to a 
civil action shall 
include a copy of the 
complaint to be filed 
to initiate the civil 
action.

``(CC) Exception.--
If it is not feasible 
for the attorney 
general of a State to 
provide the 
notification required 
by subitem (AA) before 
initiating an action 
under subclause (I), 
the attorney general of 
the State shall notify 
the Attorney General 
immediately upon 
instituting the civil 
action.

``(bb) Intervention by the 
attorney general.--The Attorney 
General may--

``(AA) intervene in 
any action brought by 
the attorney general of 
a State under subclause 
(I); and

``(BB) upon 
intervening under 
subitem (aa), be heard 
on all matters arising 
in the civil action and 
file petitions for 
appeal of a decision in 
the action.

``(iii) Limitation on state action while 
federal action is pending.--If the Attorney 
General institutes an action under clause (i) 
with respect to a triggering event, a State may 
not, during the pendency of that action, 
institute an action under clause (ii) against 
any defendant named in the complaint in the 
action instituted by the Attorney General based 
on the same set of facts giving rise to the 
triggering event with respect to which the 
Attorney General instituted the action.
``(iv) Affirmative defense.--It shall be an 
affirmative defense in an action under this 
section if the applicable covered party shows 
by clear and convincing evidence that the 
covered party could not prevent the triggering 
event.
``(C) Deposit.--
``(i) In general.--Subject to clause (ii), 
any covered compensation clawed back in an 
action under this section shall be deposited in 
a fund created by the Attorney General and 
distributed by the Attorney General, in the 
interests of justice--
``(I) to cover shortfalls in the 
salaries, employee benefit plans, or 
other benefits owed to current or past 
employees of the target firm negatively 
affected by the behavior that is the 
basis of the action; and
``(II) to be put to use in the 
interest of serving the health care 
needs of the harmed community.
``(ii) Bankruptcy as a triggering event.--
Notwithstanding any other provision of law, if 
the entry of an order for relief under title 11 
or the commencement of any other insolvency 
proceeding is the triggering event that a 
target firm experiences, the Attorney General 
shall prioritize covering funding shortfalls in 
any pension funds benefitting harmed current or 
past employees of the target firm.
``(b) Definitions.--In this section:
``(1) Affiliate.--The term `affiliate' means--
``(A) a person that directly or indirectly owns, 
controls, or holds with power to vote, 5 percent or 
more of the outstanding voting securities of another 
entity, other than a person that holds such 
securities--
``(i) in a fiduciary or agency capacity 
without sole discretionary power to vote such 
securities; or
``(ii) solely to secure a debt, if such 
entity has not in fact exercised such power to 
vote;
``(B) a corporation 10 percent or more of whose 
outstanding voting securities are directly or 
indirectly owned, controlled, or held with power to 
vote, by another entity (referred to in this 
subparagraph as a `covered entity'), or by an entity 
that directly or indirectly owns, controls, or holds 
with power to vote, 10 percent or more of the 
outstanding voting securities of the covered entity, 
other than an entity that holds such securities--
``(i) in a fiduciary or agency capacity 
without sole discretionary power to vote such 
securities; or
``(ii) solely to secure a debt, if such 
entity has not in fact exercised such power to 
vote;
``(C) a person whose business is operated under a 
lease or operating agreement by another entity, or 
person substantially all of whose property is operated 
under an operating agreement with that other entity; or
``(D) an entity that operates the business or 
substantially all of the property of another entity 
under a lease or operating agreement.
``(2) Change in control.--The term `change in control' 
means a change in a legal right with respect to--
``(A) the power to vote more than 50 per centum of 
any class of voting securities of a corporation that 
engages in interstate commerce; or
``(B) any lesser per centum of any class of voting 
securities of a corporation that engages in interstate 
commerce that is sufficient to make the acquirer of 
such an interest a person that has the ability to 
direct the actions of that corporation.
``(3) Control person.--The term `control person'--
``(A) means--
``(i) a person--
``(I) that directly or indirectly 
owns, controls, or holds with power to 
vote, including through coordination 
with other persons, 10 percent or more 
of the outstanding voting interests of 
a corporation; or
``(II) that operates the business 
or substantially all of the property of 
a corporation under a lease or an 
operating or management agreement;
``(ii) a corporation, other than a target 
firm, that has 10 percent or more of its 
outstanding voting interests directly or 
indirectly owned, controlled, or held with 
power to vote by a person that directly or 
indirectly owns, controls, or holds with power 
to vote, including through coordination with 
other persons, 10 percent or more of the 
outstanding voting interests of another 
corporation; or
``(iii) a person that otherwise has the 
ability to direct the actions of a corporation; 
and
``(B) does not include a person that--
``(i)(I) is a limited partner with respect 
to a controlling private fund that is a 
partnership;
``(II) does not participate in the 
direction of the management or policy of a 
corporation; and
``(III) is not an insider with respect to 
the controlling private fund described in 
subclause (I);
``(ii) is a pension fund or employee 
welfare benefit plan, if neither the fund nor 
plan (as applicable), nor any beneficiary or 
affiliate of the benefit or plan, is an insider 
with respect to a controlling private fund; or
``(iii) holds the voting interests of a 
corporation solely--
``(I) in a fiduciary or agency 
capacity without sole discretionary 
power to vote the securities; or
``(II) to secure a debt, if the 
person has not--
``(aa) exercised the power 
to vote; or
``(bb) exercised any other 
governance rights with respect 
to the corporation.
``(4) Controlling private fund.--The term `controlling 
private fund' means a private fund that, directly or through an 
affiliate, becomes a control person with respect to a target 
firm through the change in control transaction with respect to 
the target firm.
``(5) Corporation.--The term `corporation' means--
``(A) a joint-stock company;
``(B) a company or partnership association 
organized under a law that makes only the capital 
subscribed or callable up to a specified amount 
responsible for the debts of the association, including 
a limited partnership and a limited liability company;
``(C) a trust; and
``(D) an association having a power or privilege 
that a private corporation, but not an individual or a 
partnership, possesses.
``(6) Covered compensation.--The term `covered 
compensation' means--
``(A) salary;
``(B) any bonus;
``(C) any compensation that is granted, earned, or 
vested based wholly or in part upon the attainment of 
any financial reporting measure or other performance 
metric;
``(D) equity-based compensation;
``(E) time- or service-based awards;
``(F) awards based on nonfinancial metrics;
``(G) any monitoring fees, management fees, 
advisory fees, accelerated monitoring fees, transaction 
fees, or fees for services not rendered;
``(H) any profits realized from the buying or 
selling of securities or assets, including any real 
property;
``(I) any severance pay;
``(J) any golden parachute benefit; or
``(K) any other transaction similar to a 
transaction described in subparagraph (H) or (I).
``(7) Covered party.--The term `covered party' means--
``(A) any current or former director, officer, or 
control person of, or agent for, a private equity firm 
or target firm;
``(B) any current or former shareholder or joint 
venture partner that participates in the conduct of the 
affairs of a target firm; or
``(C) any private fund.
``(8) Employee welfare benefit plan.--The term `employee 
welfare benefit plan' has the meaning given the term in section 
3 of the Employee Retirement Income Security Act of 1974 (29 
U.S.C. 1002).
``(9) Insider.--The term `insider' means any--
``(A) director of a corporation;
``(B) officer of a corporation;
``(C) managing agent of a corporation;
``(D) control person with respect to a corporation;
``(E) affiliate of a corporation;
``(F) general partner of a corporation that is a 
partnership;
``(G) consultant or contractor retained by a 
corporation;
``(H) affiliate, relative, or agent of a person 
described in any of subparagraphs (A) through (F); or
``(I) affiliate, relative, or agent of a person 
described in subparagraph (H).
``(10) Interest coverage.--The term `interest coverage' 
means the revenue of the target firm less the expenses of the 
target firm, excluding tax and interest, during the most recent 
fiscal year of the target firm.
``(11) Pension fund.--The term `pension fund' has the 
meaning given the term `pension plan' in section 3 of the 
Employee Retirement Security Act of 1974 (29 U.S.C. 1002).
``(12) Private fund.--The term `private fund' means a 
corporation that--
``(A) would be considered an investment company 
under section 3 of the Investment Company Act of 1940 
(15 U.S.C. 80a-3) but for the application of paragraph 
(1) or (7) of subsection (c) of that section;
``(B) is not a venture capital fund, as defined in 
section 275.203(l)-1 of title 17, Code of Federal 
Regulations, as in effect on the date of enactment of 
this Act; and
``(C) is not an institution selected under section 
107 of the Community Development Banking and Financial 
Institutions Act of 1994 (12 U.S.C. 4706).
``(13) Reasonable salary.--The term `reasonable salary' 
means the amount that would ordinarily be paid for like 
services by like enterprises under like circumstances.
``(14) Relative.--The term `relative' means an individual 
related by affinity or consanguinity within the third degree as 
determined by the common law, or individual in a step or 
adoptive relationship within such third degree.
``(15) Security.--The term `security' has the meaning given 
the term in section 2(a) of the Securities Act of 1933 (15 
U.S.C. 77b(a)).
``(16) Target firm.--The term `target firm' means a health 
care corporation that is acquired in a change in control 
transaction.
``(17) Triggering event.--The term `triggering event' 
means--
``(A) any time at which a target firm is behind on 
salary payments greater than 25 percent of the total 
workforce of the target firm for a period of more than 
90 days;
``(B) closure of the target firm;
``(C) if the target firm is behind on rent payments 
for a period of more than 90 days;
``(D) if the target firm defaults on a loan for a 
period of more than 90 days; or
``(E) the entry of an order for relief under title 
11 on behalf of the target firm or the commencement of 
any other insolvency proceeding.
``(18) Unjust enrichment.--The term `unjust enrichment' 
means the acquisition of covered compensation by a covered 
party from the target firm during the 10-year period preceding 
or succeeding a triggering event if any of the following 
aggravating circumstances are established:
``(A) The covered compensation was obtained through 
a dividend recapitalization, a sale-leaseback of real 
estate or equipment, or a related person transaction, 
as set forth in section 229.404 of title 17, Code of 
Federal Regulations.
``(B) The covered party has been implicated in any 
white-collar crime, as defined in section 901 of title 
I of the Omnibus Crime Control and Safe Streets Act of 
1968 (34 U.S.C. 10251), committed in the course of the 
current or former employment of the covered party.
``(C) The covered party has charged the target firm 
accelerated monitoring fees or fees for services not 
rendered.
``(D) At the time of the issuance of the covered 
compensation, or as the result of the issuance of the 
covered compensation, the target firm had an interest 
coverage in excess of 100 percent.''.
(b) Technical and Conforming Amendment.--The table of sections for 
chapter 31 of title 18, United States Code, is amended by adding at the 
end the following:

``671. Unjust enrichment clawback and criminal penalty.
``672. Criminal penalty.
``673. Civil penalty.
``674. Clawback.''.

SEC. 3. PROHIBITING PAYMENTS FROM FEDERAL HEALTH CARE PROGRAMS TO 
ENTITIES THAT SELL ASSETS TO OR USE ASSETS AS COLLATERAL 
FOR A LOAN WITH A REAL ESTATE INVESTMENT TRUST.

Section 1128(a) of the Social Security Act (42 U.S.C. 1320a-7(a)) 
is amended by adding at the end the following new paragraph:
``(5) Selling assets to or using assets as collateral for a 
loan with a real estate investment trust.--
``(A) In general.--Any individual or entity that, 
on or after the date of enactment of this paragraph, 
sells any assets to, or newly pledges any assets as 
collateral for a loan with, a real estate investment 
trust (as defined in section 856(a) of the Internal 
Revenue Code of 1986).
``(B) Clarification.--Subparagraph (A) shall not 
apply in the case where an individual or entity agreed 
to pledge an asset as collateral for a loan with a real 
estate investment trust prior to the date of enactment 
of this paragraph, including with respect to any future 
agreement between the individual or entity and the real 
estate investment trust regarding that same asset.''.

SEC. 4. REPEAL OF SPECIAL RULE FOR TAXABLE REIT SUBSIDIARIES WITH 
INTERESTS IN CERTAIN HEALTH CARE PROPERTY.

(a) In General.--Section 856(d)(8)(B) of the Internal Revenue Code 
of 1986 is amended--
(1) by striking ``or a qualified health care property (as 
defined in subsection (e)(6)(D)(i))'', and
(2) by striking ``qualified health care property or''.
(b) Conforming Amendments.--Section 856(d)(9) of such Code is 
amended--
(1) in subparagraph (A)--
(A) by striking ``or a qualified health care 
property (as defined in subsection (e)(6)(D)(i))'',
(B) by striking ``or qualified health care 
property'', and
(C) by striking ``or qualified health care 
properties'', and
(2) in subparagraph (B)--
(A) by striking ``or qualified health care property 
(as so defined)'', and
(B) by striking ``or qualified health care 
property'' each place it appears in clauses (i), (ii), 
and (iii)(II).
(c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after the date of the enactment of 
this Act.

SEC. 5. ELIMINATION OF QUALIFIED REIT DIVIDENDS FROM QUALIFIED BUSINESS 
INCOME.

(a) In General.--Paragraph (1) of section 199A(b) of the Internal 
Revenue Code of 1986 is amended to read as follows:
``(1) In general.--The term `combined qualified business 
income amount' means, with respect to any taxable year, an 
amount equal to the sum of the amounts determined under 
paragraph (2) for each qualified trade or business carried on 
by the taxpayer.''.
(b) Conforming Amendments.--
(1) Section 199A(c)(1) of such Code is amended by striking 
the last sentence.
(2) Section 199A(e) of such Code is amended by striking 
paragraph (3) and by redesignating paragraph (4) as paragraph 
(3).
(c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after the date of the enactment of 
this Act.

SEC. 6. MANDATORY REPORTING WITH RESPECT TO CERTAIN HEALTH-RELATED 
OWNERSHIP INFORMATION.

Part A of title XI of the Social Security Act (42 U.S.C. 1301 et 
seq.) is amended by adding at the end the following new section:

``SEC. 1150D. MANDATORY REPORTING WITH RESPECT TO CERTAIN HEALTH-
RELATED OWNERSHIP INFORMATION.

``(a) Mandatory Reporting With Respect Certain Health-Related 
Ownership Information.--
``(1) Reporting.--Not later than January 1, 2027 (or in the 
case of a specified entity formed after January 1, 2027, within 
60 days of becoming a specified entity), and each year 
thereafter, each specified entity (as defined in subsection 
(e)(8)) shall submit to the Secretary, in a form and manner 
specified by the Secretary, a report containing the following 
information, subject to paragraph (3)(B):
``(A) Data on mergers, acquisitions, changes in 
ownership, changes in control, transactions to form new 
affiliations, changes in partnerships, joint ventures, 
and/or management services agreements, to which such 
specified entity is a party for the previous 1-year 
period, including--
``(i) the primary reason the reporting 
entity completed the acquisition; and
``(ii) a description of how the acquirer 
obtained control of the acquiree, and the 
percentage of ownership acquired (i.e., voting 
equity interests).
``(B) As applicable, the name, address, tax or 
health plan identification numbers (including, without 
limitation, the tax identification number, National 
Association of Insurance Commissioners identification 
number, State insurance identification number, Medicare 
provider number, and the standard unique health 
identifier (as described in section 1173(b))) of all 
health care providers within the specified entity that 
furnish items or services.
``(C) Business structure of any controlling entity, 
including the business type and the tax identification 
number of such entity, other affiliates under common 
control, subsidiaries, and management services entities 
of such specified entity, as of the date of the 
submission of this report.
``(D) Information regarding--
``(i) the debt-to-earnings ratio of the 
specified entity;
``(ii) the amount of debt incurred--
``(I) by each hospital or separate 
entity within the health system; and
``(II) by the entire specified 
entity;
``(iii) real estate leases and purchases 
for property used, or intended to be used, to 
furnish or otherwise support the provision of 
health care services, including expenditures on 
rents and maintenance, property taxes paid, and 
the name of the company leased from;
``(iv) details of other companies' revenue 
sharing arrangement;
``(v) fees charged or dividends paid to 
investors;
``(vi) in the case of a non-profit 
hospital, a subsidiary of a non-profit 
hospital, or a 501(c)(3) entity that shares 
common ownership with a non-profit hospital, 
capital gains investments (disaggregated by the 
type of investment) and any taxes paid on such 
gains from such investments; and
``(vii) information with respect to any 
controlling entity of such specified entity.
``(E) The value of quality payments received for 
performance under any value-based or other performance-
based program such as the shared savings program under 
section 1899.
``(F) Any other information with respect to 
ownership or control of a specified entity, as 
determined by the Secretary.
``(G) Any changes to the health care providers 
within the specified entity that furnish items or 
services during the previous 1-year period, identified 
by the National Provider identifier described in 
section 1173(b).
``(H) The domicile and business registration 
information for any controlling entity or subsidiary of 
such controlling entity that is domiciled outside of 
the United States.
``(2) Avoiding duplicate reporting.--If a specified entity 
is owned or controlled by an entity described in subparagraph 
(G) of subsection (f)(8), only the entity described in such 
subparagraph (G) shall be required to submit reports under this 
subsection with respect to such entity and any specified entity 
owned or controlled by the entity.
``(3) Availability of information and public reporting.--
``(A) In general.--Not later than January 1, 2028, 
and annually thereafter, subject to subparagraph (B), 
the Secretary shall post on a publicly available 
website of the Department of Health and Human Services 
the information reported under this subsection with 
respect to the previous 1-year period for which the 
information was collected.
``(B) Requirement.--In making information reported 
under this subsection publicly available under 
subparagraph (A), the Secretary shall do so in a manner 
that does not disclose the social security number of 
any individual provider of services or supplier.
``(b) Audits.--The Secretary shall conduct an annual audit 
consisting of a random sample of specified entities to verify 
compliance with the requirements of this section and the accuracy of 
information submitted pursuant to this section.
``(c) Penalty for Failure To Report.--If a specified entity fails 
to provide a complete report under subsection (a), or submits a report 
containing false information, such entity shall be subject to a civil 
monetary penalty of not more than $5,000,000 for each such report not 
provided or containing false information. Such penalty shall be imposed 
and collected in the same manner as civil money penalties under 
subsection (a) of section 1128A are imposed and collected under that 
section.
``(d) Inapplicability of Paperwork Reduction Act.--Chapter 35 of 
title 44, United States Code, shall not apply to collections of 
information made under this section.
``(e) Definitions.--In this section:
``(1) Control.--The term `control' means the direct or 
indirect power through ownership, contractual agreement, or 
otherwise--
``(A) to vote more than 5 percent of any class of 
voting securities of a specified entity; or
``(B) to direct the actions of the specified 
entity.
``(2) Controlling entity.--
``(A) In general.--The term `controlling entity' 
means, with respect to any specified entity, a parent 
company or other entity that owns or controls the 
specified entity through ownership, contractual 
agreement, or otherwise.
``(B) Inclusion of reits.--Such term includes, with 
respect to a specified entity, a real estate investment 
trust (as defined in section 856 of the Internal 
Revenue Code of 1986) that owns property where the 
specified entity furnishes health care items or 
services.
``(3) Health plan.--The term `health plan' has the meaning 
given such term in section 1128C(c).
``(4) Health system.--The term `health system' means a 
group of health care organizations (such as physician 
practices, hospitals, skilled nursing facilities) that are 
jointly owned or managed.
``(5) Hospital.--The term `hospital' has the meaning given 
such term in section 1861(e).
``(6) Independent freestanding emergency department.--The 
term `independent freestanding emergency department' has the 
meaning given such term in section 2799A-1(a)(3)(D) of the 
Public Health Service Act.
``(7) Private fund.--The term `private fund' means a 
corporation that--
``(A) would be considered an investment company 
under section 3 of the Investment Company Act of 1940 
(15 U.S.C. 80a-3) but for the application of paragraph 
(1) or (7) of subsection (c) of such section 3;
``(B) is not a venture capital fund, as defined in 
section 275.203(l)-1 of title 17, Code of Federal 
Regulations, as in effect on the date of enactment of 
this section; and
``(C) is not an institution selected under section 
107 of the Community Development Banking and Financial 
Institutions Act of 1994 (12 2 U.S.C. 4706).
``(8) Specified entity.--The term `specified entity' 
means--
``(A) a hospital or health system;
``(B) a physician-owned physician practice (other 
than a practice described in subparagraph (C)) that is 
enrolled in the Medicare program under title XVIII 
under section 1866(j);
``(C) a physician practice owned, controlled, under 
common control, or under management agreement by a 
hospital, health system, a health plan, a private fund, 
a venture capital fund, a public or private 
corporation, or any subsidiaries or entities under 
common control thereof;
``(D) an ambulatory surgical center meeting the 
standards specified under section 1832(a)(2)(F)(i);
``(E) an independent freestanding emergency 
department;
``(F) a behavioral health treatment facility, a 
hospice program (as defined in section 1861(dd)(2)), a 
home health agency, a provider of services or renal 
dialysis facility that furnishes renal dialysis 
services, or an assisted living facility;
``(G) any other entity specified by the Secretary 
that furnishes health care items and services; and
``(H) any entity that owns or controls 1 or more 
specified entities.
``(9) Venture capital fund.--The term `venture capital 
fund' has the meaning given such term in section 275.203(l)-1 
of title 17, Code of Federal Regulations.''.

SEC. 7. REPORT ON MORAL INJURY IN HEALTH CARE.

(a) In General.--Not later than 3 years after the date of enactment 
of this Act, the Inspector General of the Department of Health and 
Human Services shall--
(1) conduct a study that evaluates profit-driven practices, 
including cost-cutting practices and revenue-enhancing 
practices, in health care delivery; and
(2) submit to Congress a report describing the results of 
such study.
(b) Inclusions.--The study conducted under subsection (a)(1) shall 
include--
(1) an evaluation of profit-driven and revenue-maximization 
practices in health care delivery, including--
(A) overbilling or up-coding;
(B) inflated patient severity or patient risk 
scores;
(C) executive and provider compensation designed to 
increase revenue or profits, such as bonuses based on 
productivity, relative value units, or service volume;
(D) reductions in staff and substitution of patient 
care staff with technology;
(E) changes in the mix of services provided in 
order to maximize revenue;
(F) efforts by private health insurers that are 
designed to restrict, delay, deny, or discourage health 
care access services, such as prior authorization or 
utilization review mechanisms; and
(G) efforts by private health insurers, private 
equity firms, and other corporate entities to evade 
state Corporate Practice of Medicine laws;
(2) an evaluation of the impact of such practices on--
(A) the quality, safety, and outcomes of patient 
care;
(B) the well-being of personnel providing health 
care services;
(C) the Medicare program under title XVIII of the 
Social Security Act (42 U.S.C. 1395 et seq.);
(D) the Medicaid program under title XIX of such 
Act (42 U.S.C. 1396 et seq.);
(E) health care furnished under the laws 
administered by the Secretary of Veterans Affairs;
(F) the health insurance program carried out under 
chapter 89 of title 5, United States Code;
(G) qualified health plans offered through American 
Health Benefit Exchanges established under section 1311 
or 1321 of the Patient Protection and Affordable Care 
Act (42 U.S.C. 18031, 18041); and
(H) group health plans and group and individual 
health insurance coverage, including managed care 
plans;
(3) an estimate of the financial returns accruing to 
parties that benefit from such practices, including investors 
and other entities; and
(4) an evaluation of the adequacy of Federal policies 
designed to prevent and penalize health care fraud and abuse, 
given health care consolidation and integration, including the 
transparency of health care entities' financial practices, the 
enforcement resources of Federal agencies, and the adequacy of 
financial and other penalties as deterrents.
<all>