The Patients Over Profit Act prohibits health insurance companies and certain healthcare providers from being owned or controlled by the same entity. The bill targets potential conflicts of interest where an insurance company could profit by limiting care from providers it owns. Companies that currently have this dual ownership must divest (sell off) either their insurance business or their healthcare provider operations within two years of the bill's enactment; those acquiring such businesses after enactment have one year to comply. Federal enforcement agencies—including the Federal Trade Commission, Department of Justice, and state attorneys general—can file lawsuits to force compliance and require companies to return revenues earned during violations, with those funds distributed to affected communities. The bill specifically applies these rules to Medicare Advantage and Medicare Part D plans starting January 1, 2026, effectively barring non-compliant organizations from contracting with Medicare.
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