The bill creates multiple new statutory sections and amends existing provisions to limit non‑medical control of medical practice and to protect clinicians’ professional judgment. It adds a new section to chapter 18.100 RCW and related provisions that generally make it unlawful for non‑medical persons or entities to own a medical practice, employ licensed health care providers, or otherwise engage in the practice of medicine except as permitted by law. Professional service corporations organized for medical practice must have medical licensees hold all voting shares, all director positions, and all officer positions except secretary and treasurer; shareholder medical licensees must be substantially engaged in care delivery or practice management. The bill prohibits certain ownership, transfer, compensation, and management arrangements with management services organizations (MSOs) unless the MSO is wholly owned by medical licensees, and bars medical licensees from relinquishing control over administrative, business, or clinical operations that affect clinical decision making except to other medical licensees. The bill also adds new sections across health care settings (hospitals, ambulatory surgical facilities, nursing homes, birthing centers, in‑home services agencies, telemedicine‑exclusive practices, HMOs, and health care service contractors) that prohibit persons other than specified licensed physicians, osteopathic physicians, advanced registered nurse practitioners, or their licensed designees from interfering with, controlling, or directing the professional judgment or ultimate clinical decisions of licensed health care providers acting within their scope. The new sections give examples of prohibited conduct (for example, controlling time with patients, discharge timing, clinical status decisions, diagnoses or codes entered, and configuring medical records to limit clinical orders) and include carve‑outs for policies necessary to comply with state or federal law, coding guidelines, third‑party payor requirements, credentialing, privileging, quality improvement, peer review, regulatory or CMS conditions, and the physician health program. For telemedicine‑exclusive practices the bill states a violation is an unfair or deceptive act under the Consumer Protection Act and assigns enforcement to the attorney general. The bill changes enforcement and disciplinary procedures. It amends unprofessional conduct lists and enforcement authority to allow notices of intention, temporary and permanent cease‑and‑desist orders, civil fines up to $1,000 per day for unlicensed practice, and injunctive relief; it sets a 20‑day deadline to request an adjudicative hearing after a notice of intention to issue a cease‑and‑desist order and treats a single unlicensed practice violation as a gross misdemeanor and each subsequent violation as a class C felony. It requires certain license applicants/renewals to attest awareness of the new corporate practice rules, and it amends franchise registration stop‑order authority to include violations of the act. The act’s effective date is stated as January 1, 2028. Several definitions and complete text for referenced sections (including section 1 definitions, the telemedicine‑exclusive practice definition in section 8, and parts of the section added to chapter 71.12 RCW) are not included in the provided extracts, so some implementation details and cross‑references are unclear from the materials given.

If enacted, the law would sharply limit non‑clinicians and investor groups from owning or running medical practices and from directing clinical decisions in many care settings. Physician and other licensed clinicians would generally need to hold voting control and top management roles in professional service corporations, be actively involved in patient care or practice management, and could not outsource ownership or clinical control to outside management services organizations unless those MSOs are wholly owned by licensees. The bill also bars non‑clinical managers, payers, and contractors from using policies or incentives to control how long clinicians spend with patients, discharge timing, diagnoses or codes, or the clinical orders available to providers in hospitals, nursing homes, ambulatory surgical centers, birthing centers, in‑home agencies, telemedicine‑only practices, HMOs, and integrated contractors; telemedicine misuse would be actionable as consumer protection. The groups most affected will be non‑physician investors, private equity–backed MSOs, and any practice that currently relies on outside management or ownership: they likely face restructuring costs, buyouts, lost revenue streams from management fees or control arrangements, and new legal risks including cease‑and‑desist orders, civil fines (up to $1,000 per day), and possible criminal penalties for unlicensed practice. Licensed clinicians will gain greater control but also more managerial responsibility and potential liability; hospitals, federally qualified health centers, HMOs, and several facility types are carved out so they will see less change. Some important implementation details—such as the exact statutory definitions of “medical licensee,” “management services organization,” and “telemedicine‑exclusive” referenced elsewhere in the act—are not included here, so how certain provisions apply in practice remains partly unclear. The act takes effect January 1, 2028.