The push by states to keep tabs on not-for-profit hospitals and insurers that want to convert to for-profit status shows no sign of letting up.
So far this year, 84 bills aimed at regulating not-for-profit conversions are pending in 31 state legislatures, according to the Washington-based National Conference of State Legislatures.
Besides new proposals, some of the bills are carryovers, which means they were proposed last year but weren't put to a vote. Other bills amount to a tweaking of existing laws.
Since 1990, 48 laws have been enacted in 33 states and the District of Columbia. According to a survey in the journal Health Affairs, in 1994 there were 34 hospital conversions. In 1995 that number had risen to 59, the survey said.
Minnesota is one of the states with conversion bills pending in both the state House and Senate.
Final votes are expected before the legislative session ends in April, said Richard Korman, assistant general counsel for the Minnesota Hospital and Healthcare Partnership.
Under the Minnesota bill, a not-for-profit hospital would have to notify the state attorney general of any deal to sell, transfer, lease or otherwise dispose of 50% or more of its assets to a for-profit company.
Minnesota has 139 hospitals and only one is for-profit, according to the state hospital group.
Once the state is notified of a pending deal, the attorney general will review it and can try to stop it if the deal doesn't jibe with the fiduciary obligations of the not-for-profit.
"It's just a check to make sure the assets of the nonprofit healthcare trust are maintained or spent in furtherance of the original goal that established the hospital," Korman said.