The bill adds new statutory sections and amends existing law to restrict non-licensed persons and entities from practicing medicine, owning or controlling medical practices, employing licensed health care providers in ways that affect clinical decision making, or otherwise relinquishing de facto control over clinical, staffing, billing, coding, and related decisions. It imposes corporate governance requirements for professional service corporations formed under chapter 18.100 RCW (majority of voting shares and directors held by Washington-licensed health care providers, licensed providers holding most officer positions, and majority shareholders present in the state and substantially engaged in care and practice management). The bill prohibits certain financial and management arrangements with management services organizations, creates parallel prohibitions preventing unlicensed persons affiliated with hospitals, private establishments, ambulatory surgical facilities, birthing centers, hospice agencies, and (incompletely shown) nursing homes from interfering with licensed providers’ professional judgment, and defines “management services organization.” Several specified entities are exempt from the Sec. 1 corporate-practice rule as described in the text excerpt. The bill also makes procedural and disciplinary changes: it amends RCW 18.130.180 to list violating sections 1–7 of the act as unprofessional conduct, adds license-application and renewal attestations across numerous licensing chapters that applicants are aware of the corporate-practice regulations in sections 1–7, and amends RCW 19.100.120 to permit the director to issue stop orders against registration statements on several grounds including illegal business activities such as violations of section 1. These are new statutory prohibitions, corporate governance rules, a procedural attestation requirement, and amendments expanding disciplinary and regulatory enforcement authority. Important context is missing from the provided excerpts: the full text of sections 1–7 is not entirely included (Sec. 5 is incomplete), the full amendment language for some referenced RCWs is not shown, and no effective dates, penalty scales, detailed enforcement processes, or definitions for several key terms (for example “substantially engaged” or “licensed health care provider”) appear in the extracted facts.

If enacted, the law would sharply limit the ability of people or companies without a Washington medical license to own, control, or run medical practices or to direct clinical decisions in hospitals, nursing homes, ambulatory surgical centers, birthing centers, and hospice agencies. Medical practices using a professional service corporation would need licensed Washington health care providers to hold the voting shares, a majority of directors, and most officer roles, with those majority owners physically in-state and actively involved in care and practice management. Management services organizations and outside owners would be blocked from controlling hiring, staffing levels, billing, clinical standards, coding, pricing, and third-party contract negotiations that affect clinical decision making, and similar interference by non-licensed persons would be treated as unprofessional conduct; applicants for many health-related licenses would have to attest they know these rules. The groups most affected are professional service corporations, non-physician owners and management companies that currently provide administrative control or capital, and hospitals and licensed care facilities that contract with non-licensed administrators. Those entities may need to restructure ownership and governance, change contracts with management companies, or give up certain management arrangements, which could raise transaction and compliance costs and reduce options for outside financing or centralized management. Health care facilities will likely face increased compliance and oversight responsibilities and potential risk of discipline if non-licensed parties are found to be directing clinical care. Important details are missing from the excerpts—such as precise enforcement mechanisms, penalties, definitions like “substantially engaged” or “substantial compensation,” and the full nursing home provision—so how aggressively these rules would be applied and enforced is unclear.