SB45,1143,8 a. Health care costs, prices, and affordability.

SB45,1143,10 b. The availability or accessibility of health care services to the affected community.

SB45,1143,12 c. Health care provider cost trends and containment of total state health care spending.

SB45,1143,13 d. Access to services in medically underserved areas.

SB45,1143,15 e. Rectifying historical and contemporary factors contributing to a lack of health equities or access to services.

SB45,1143,17 f. The functioning and competitiveness of the markets for health care and health insurance.

SB45,1143,19 g. The potential effects of the material change transaction on health outcomes, quality, access, equity, or workforce for residents of this state.

SB45,1143,20 h. The potential loss of or change in access to essential services.

SB45,1143,23 2. Whether the material change transaction is contrary to or violates any applicable law, including state antitrust laws, laws restricting the corporate practice of medicine, or consumer protection laws.

SB45,1144,2 3. Whether the benefits of the transaction are likely to outweigh any anticompetitive effect from the transaction.

SB45,1144,3 4. Whether the transaction is in the public interest.

SB45,1144,6 (d) This subsection does not limit or alter any existing authority of the attorney general or any state agency to enforce any other law, including state or federal antitrust law, or to review nonprofit transactions.

SB45,1144,10 (5) Post-transaction oversight. (a) Enforcement by the attorney general. 1. The attorney general may subpoena any records necessary to enforce any provisions of this section or to investigate suspected violations of any provisions of this section or any conditions imposed by conditional approval pursuant to sub. (4).

SB45,1144,18 2. The attorney general may enforce any requirement of this section and any conditions imposed by a conditional approval pursuant to sub. (4) to the fullest extent provided by law, including damages. In addition to any legal remedies the attorney general may have, the attorney general shall be entitled to specific performance, injunctive relief, and other equitable remedies a court deems appropriate for any violations or imminent violation of any requirement of this section or breach of any of the conditions and shall be entitled to recover its attorney fees and costs incurred in remedying each violation.

SB45,1144,24 3. In addition to the remedies set forth in subd. 2., any person who violates this section or of any conditions imposed pursuant to a conditional approval under sub. (4) is subject to a forfeiture of $10,000 per day, which the attorney general may seek to recover by action on behalf of the state. The attorney general may also rescind or deny approval for any other past, pending, or future material change transactions involving the health care entity or an affiliate.

SB45,1145,3 4. Nothing in this paragraph shall narrow, abrogate, or otherwise alter the authority of the attorney general to prosecute violations of antitrust or consumer protection requirements.

SB45,1145,6 (b) Enforcement by the department. 1. The department may audit the books, documents, records, and data of any entity that is subject to a conditional approval under sub. (4) to monitor compliance with the conditions.

SB45,1145,10 2. Any entity that violates any provision of this section, any rules adopted pursuant thereto, or any condition imposed pursuant to a conditional approval under sub. (4) shall be subject to a forfeiture of $10,000 per day for any violation of this section.

SB45,1145,13 3. The department may refer any entity to the attorney general to review for enforcement of any noncompliance with this section and any conditions imposed by conditional approval pursuant to sub. (4).

SB45,1145,18 (c) Monitoring. In order to effectively monitor ongoing compliance with the terms and conditions of any material change transaction subject to prior notice, approval, or conditional approval under sub. (4), the department may, in its sole discretion, conduct a review or audit and may contract with experts and consultants to assist in this regard.

SB45,1146,2 (d) Reporting. One year, 2 years, and 5 years following the completion of the material change transaction approved or conditionally approved by the department after a comprehensive review under sub. (3), and upon future intervals determined at the discretion of the department, the health care entity or any person, corporation, partnership, or other entity that acquired direct or indirect control over the health care entity shall submit reports to the department that do all of the following:

SB45,1146,4 1. Demonstrate compliance with conditions placed on the material change transaction, if any.

SB45,1146,5 2. Analyze cost trends and cost growth trends of the transacting parties.

SB45,1146,7 3. Analyze any changes or effects of the material change transaction on patient access, availability of services, workforce, quality, or equity.

SB45,1146,11 (e) Costs. The department shall be entitled to charge costs to the transacting parties for all actual, reasonable, and direct costs incurred in monitoring ongoing compliance with the terms and conditions of the sale or transfer of assets, including contractor and administrative costs.

SB45,1146,12 (6) Rules. The department may promulgate rules to implement this section.

SB45,2209 Section 2209. 150.994 of the statutes is created to read:

SB45,1146,16 150.994 Corporate practice of medicine. The corporate practice of medicine is prohibited. The department shall promulgate rules to define what conduct constitutes the corporate practice of medicine for purposes of this section.

SB45,2210 Section 2210. 150.996 of the statutes is created to read: