This bill amends existing statutes in chapter 19.390 RCW and RCW 70.45.020, and adds new sections to chapter 19.390 RCW and chapter 24.03A RCW. It authorizes the attorney general to enter into or revise memoranda of understanding with the Department of Health, the Office of the Insurance Commissioner, and the Health Care Authority to facilitate exchange of data and information for purposes of the covered 19.390 provisions. It also requires the Secretary of State to revoke a hospital’s, hospital system’s, or provider organization’s nonprofit or foreign nonprofit corporation designation when certain transaction conditions are met, and directs those entities to follow the processes in chapter 70.45 RCW after revocation. The bill establishes procedural requirements for transactions that cause a “material change.” Parties must give written notice to the attorney general at least 60 days before the transaction’s effective date. The attorney general must request any additional information within 30 days of notice; if such a request is made, the transaction may not proceed until 30 days after substantial compliance with the request, and further requests may not continue to delay the transaction. The bill defines material change to include mergers, acquisitions, contracting affiliations among hospitals, hospital systems, or provider organizations, changes in ownership or control, certain significant asset transactions including sale and leaseback of real property, and nonprofit-to-for-profit or nonprofit-to-unincorporated conversions. It also covers proposed transactions involving an out-of-state entity that generates $10 million or more in health care services revenue from Washington patients. Legally, the bill creates procedural and regulatory changes: it adds administrative authority for interagency information sharing, imposes notice and review procedures for specified health care transactions, and creates a statutory mechanism for Secretary of State revocation of nonprofit corporate status under defined circumstances. It also clarifies that the attorney general may later investigate or enforce state or federal antitrust laws. The text of RCW 19.390.040 is referenced but not included in the provided material, so the full scope of permitted information exchange and any requirements in that section cannot be confirmed from these extracts.

If enacted, hospitals, hospital systems, and provider organizations would have to give the Washington attorney general written notice at least 60 days before many mergers, acquisitions, contracting affiliations, large asset deals, or conversions that change ownership or control. The attorney general could ask for more information within 30 days and, if information is requested, the transaction cannot move forward until 30 days after the parties substantially comply; the Secretary of State would be required to revoke a hospital or provider organization’s nonprofit or foreign nonprofit corporate designation in specified for‑profit or unincorporated transaction situations, after which those entities must follow the state processes in chapter 70.45 RCW. The bill also authorizes the attorney general to enter memoranda of understanding with the Department of Health, the Insurance Commissioner, and the Health Care Authority to share data for these reviews, and it brings some out‑of‑state players into scope when they generate $10 million or more from Washington patients. The most affected parties are nonprofit hospitals, hospital systems, and provider organizations, which will face new notification duties, potential delays while responding to information requests, and the real risk of losing nonprofit corporate designation in certain transactions—changes that could increase legal and administrative costs, alter strategic options for sales or mergers, and subject them to additional state review procedures. State agencies (the attorney general, Department of Health, Insurance Commissioner, Health Care Authority, and Secretary of State) will take on clearer roles in review and oversight. The summary omits the text of RCW 19.390.040 and some cross‑referenced definitions, so the full scope of information the attorney general may seek and certain definitional details cannot be confirmed here.