Robinson Cole LLP
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Michael G. Lisitano represents hospitals, health systems, physician groups, and other health care entities and providers on a variety of health law issues including advising health care clients in regulatory, transactional, and general corporate matters.

Regulatory

Michael advises health care clients on various regulatory matters, such as Medicare and Medicaid program compliance; the Physician Self-Referral Law, Anti-Kickback Statute, False Claims Act and other federal fraud and abuse laws; compliance with the Health Insurance Portability and Accountability Act (HIPAA); and the No Surprises Act. Michael also assists clients in state health law matters including certificates of need, provider and facility licensing laws, and scope of practice issues.

Transactional

Michael provides counsel to health care entities in corporate transactions, particularly those between or among physician groups, hospitals and health systems. He assists with transactions involving contracting, affiliations, clinical services agreements, and physician-hospital organizations. Michael also represents health care entities in negotiating reimbursement contracts with commercial health insurers.

He also advises nonprofit hospitals on corporate matters specific to nonprofit entities. Michael is an adjunct professor at Quinnipiac University School of Law teaching Nonprofit Organizations Law.

While in law school, Michael served as the Research and Symposium Editor of the Quinnipiac Law Review. He received the Academic Excellence Award, Superior Classroom Performance Award, Service to the Law School Award, and distinguished academic achievement awards in Health Care and Hospital Administration Law, Drug and Device Law, Contract Law, Civil Procedure, and Legal Skills.

Michael is a contributor to our firm's blog, Health Law Diagnosis

  • Quinnipiac University School of Law (Juris Doctor, summa cum laude)
    • Dean’s Fellow
    • Law Review
  • Eastern Connecticut State University (Bachelors, magna cum laude)
    • B.A., History

  • State of Connecticut
  • Commonwealth of Massachusetts

Experience


Represented Help at Home in Acquisition of Home Care Now of Central Florida

Represented Help at Home, a nationwide leading provider of innovative, relationship-driven, in-home personal care, in its acquisition of Home Care Now of Central Florida, a state-licensed home care agency providing personalized home health services in central Florida. The acquisition will see Help at Home expand and strengthen its Florida presence to provide home care services across every county throughout the state.

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Represented Help at Home in Acquisition of Home Care Now of Central Florida

Health Care Provider Representation

Provides regular representation of health care providers such as hospitals and nursing homes on matters of corporate governance, contracts, regulatory compliance, corporate compliance, risk management, and litigation.

No Surprises Act Advice

Provides advice to hospitals regarding issues involving the No Surprises Act.



Publications


Connecticut Heightens Scrutiny of Private Equity in Healthcare with Law Banning Hospital Sale-Leaseback Agreements and Requiring Private Equity Attestations teaser
June 17, 2026

Connecticut Heightens Scrutiny of Private Equity in Healthcare with Law Banning Hospital Sale-Leaseback Agreements and Requiring Private Equity Attestations

Health Law Diagnosis
Connecticut Establishes New Process for Hospitals Seeking to Pause or Terminate Service Lines teaser
May 28, 2026

Connecticut Establishes New Process for Hospitals Seeking to Pause or Terminate Service Lines

Health Law Diagnosis
Everything Old is New Again: Connecticut Revamps Certificate of Need (CON) Program under Department of Public Health teaser
May 19, 2026

Everything Old is New Again: Connecticut Revamps Certificate of Need (CON) Program under Department of Public Health

Health Law Diagnosis
Connecticut Heightens Scrutiny of Private Equity in Healthcare with Law Banning Hospital Sale-Leaseback Agreements and Requiring Private Equity Attestations teaser
June 17, 2026

Connecticut Heightens Scrutiny of Private Equity in Healthcare with Law Banning Hospital Sale-Leaseback Agreements and Requiring Private Equity Attestations

Health Law Diagnosis
Connecticut Establishes New Process for Hospitals Seeking to Pause or Terminate Service Lines teaser
May 28, 2026

Connecticut Establishes New Process for Hospitals Seeking to Pause or Terminate Service Lines

Health Law Diagnosis
Everything Old is New Again: Connecticut Revamps Certificate of Need (CON) Program under Department of Public Health teaser
May 19, 2026

Everything Old is New Again: Connecticut Revamps Certificate of Need (CON) Program under Department of Public Health

Health Law Diagnosis
Massachusetts Governor Healey Announces New Department of Insurance Regulations Intended to Streamline Prior Authorization Practices teaser
January 29, 2026

Massachusetts Governor Healey Announces New Department of Insurance Regulations Intended to Streamline Prior Authorization Practices

Health Law Diagnosis
Connecticut Budget Bill Includes Notable Changes to CON Laws teaser
July 8, 2025

Connecticut Budget Bill Includes Notable Changes to CON Laws

Health Law Diagnosis
Health Law Diagnosis teaser
March 18, 2025

Health Law Diagnosis

Health Law Diagnosis teaser
March 4, 2025

Health Law Diagnosis

Health Law Diagnosis teaser
November 25, 2024

Health Law Diagnosis

Health Law Diagnosis teaser
October 7, 2024

Health Law Diagnosis



Massachusetts Governor Healey Announces New Department of Insurance Regulations Intended to Streamline Prior Authorization Practices teaser
January 29, 2026

Massachusetts Governor Healey Announces New Department of Insurance Regulations Intended to Streamline Prior Authorization Practices

Health Law Diagnosis
Connecticut Budget Bill Includes Notable Changes to CON Laws teaser
July 8, 2025

Connecticut Budget Bill Includes Notable Changes to CON Laws

Health Law Diagnosis
Health Law Diagnosis teaser
March 18, 2025

Health Law Diagnosis

Health Law Diagnosis teaser
March 4, 2025

Health Law Diagnosis

Health Law Diagnosis teaser
November 25, 2024

Health Law Diagnosis

Health Law Diagnosis teaser
October 7, 2024

Health Law Diagnosis


News


December 18, 2025

Business Transactions in Health Care Team Wins “Pharma & Devices Deal of the Year” at Global M&A Network’s 7th Annual USA Middle Markets M&A Atlas Awards Gala

Robinson+Cole’s Business Transactions in Health Care team won the “Pharma & Devices Deal of the Year” award presented by Global M&A Network at its the 7th Annual USA Middle Markets M&A Atlas Awards and 16th Annual Global M&A Atlas Awards Gala, on December 9, 2025, at the Metropolitan Club in New York City. The gala recognized accomplished leaders, dealmakers, outstanding firms, and the best-value creating transactions during 2025. The “Pharma & Devices Deal of the Year” award was presented for the successful sale of Acentus, a national medical supplier specializing in the delivery of continuous glucose monitors for Medicare patients, to Henry Schein, Inc., a solutions company for health care professionals advising over 1 million customers globally to improve operational success and clinical outcomes. Business Transactions in Health Care team co-chair Les Levinson led the complex deal, which saw Henry Schein acquire substantially all of Acentus’ assets, and expanded its national homecare solutions platform to address the evolving needs of its clients. The team was comprised of a cross-disciplinary group of R+C lawyers including, Kiernan Ignacio, Natale DiNatale, Nicole Diodati, Linn Freedman, Michael Kearney, Michael Lisitano, Virginia McGarrity, Kathryn Rattigan, Jacqueline Pennino Scheib, and Danielle Tangorre.

Global M&A Network
Business Transactions in Health Care Team Wins “Pharma & Devices Deal of the Year” at Global M&A Network’s 7th Annual USA Middle Markets M&A Atlas Awards Gala teaser
May 22, 2025

Health Care Transactions Team Represents Help at Home in Acquisition of Home Care Now of Central Florida

August 24, 2023

Conor Duffy, Ben Jensen and Michael Lisitano Co-Author Law360 Article on Certificate-of-Need Appeals

Law360
December 18, 2025

Business Transactions in Health Care Team Wins “Pharma & Devices Deal of the Year” at Global M&A Network’s 7th Annual USA Middle Markets M&A Atlas Awards Gala

Robinson+Cole’s Business Transactions in Health Care team won the “Pharma & Devices Deal of the Year” award presented by Global M&A Network at its the 7th Annual USA Middle Markets M&A Atlas Awards and 16th Annual Global M&A Atlas Awards Gala, on December 9, 2025, at the Metropolitan Club in New York City. The gala recognized accomplished leaders, dealmakers, outstanding firms, and the best-value creating transactions during 2025. The “Pharma & Devices Deal of the Year” award was presented for the successful sale of Acentus, a national medical supplier specializing in the delivery of continuous glucose monitors for Medicare patients, to Henry Schein, Inc., a solutions company for health care professionals advising over 1 million customers globally to improve operational success and clinical outcomes. Business Transactions in Health Care team co-chair Les Levinson led the complex deal, which saw Henry Schein acquire substantially all of Acentus’ assets, and expanded its national homecare solutions platform to address the evolving needs of its clients. The team was comprised of a cross-disciplinary group of R+C lawyers including, Kiernan Ignacio, Natale DiNatale, Nicole Diodati, Linn Freedman, Michael Kearney, Michael Lisitano, Virginia McGarrity, Kathryn Rattigan, Jacqueline Pennino Scheib, and Danielle Tangorre.

Global M&A Network
Business Transactions in Health Care Team Wins “Pharma & Devices Deal of the Year” at Global M&A Network’s 7th Annual USA Middle Markets M&A Atlas Awards Gala teaser
May 22, 2025

Health Care Transactions Team Represents Help at Home in Acquisition of Home Care Now of Central Florida

August 24, 2023

Conor Duffy, Ben Jensen and Michael Lisitano Co-Author Law360 Article on Certificate-of-Need Appeals

Law360
July 10, 2023

Conor Duffy, Michael Lisitano and Erin Howard Co-Author Law360 Expert Analysis Article on Changes to Connecticut Certificate of Need Laws

Law360
May 21, 2021

Transactional Health Law Team Represents Visiting Nurse Association and BlackTree/Simione in Recent Deals

March 29, 2021

Transactional Health Law Team Represents ViaQuest in Significant Investment Agreement


July 10, 2023

Conor Duffy, Michael Lisitano and Erin Howard Co-Author Law360 Expert Analysis Article on Changes to Connecticut Certificate of Need Laws

Law360
May 21, 2021

Transactional Health Law Team Represents Visiting Nurse Association and BlackTree/Simione in Recent Deals

March 29, 2021

Transactional Health Law Team Represents ViaQuest in Significant Investment Agreement

Events


Past

Medicare Advantage: What’s Around the Corner in 2025

Sep 12 2024
MHA Hot Topic Webinar Series
Past

Surprise Billing Rules Coming January 1, 2022 – Important Information About New Rules

Dec 16 2021
R+C-hosted webinar
Past

Medicare Advantage: What’s Around the Corner in 2025

Sep 12 2024
MHA Hot Topic Webinar Series
Past

Surprise Billing Rules Coming January 1, 2022 – Important Information About New Rules

Dec 16 2021
R+C-hosted webinar

Health Law Diagnosis


Below is an excerpt of the Health Law Diagnosis blog posts authored by Michael.

New Connecticut Law Expedites Claim Disputes Between Health Care Providers and Insurers

On May 27, 2026, Connecticut Governor Ned Lamont signed “An Act Concerning Return of Health Care Provider Payments” (PA 26-56). As of January 1, 2027, PA 26-56 shortens the time period during which commercial health insurers can look to cancel, deny, or recoup certain payments to providers, and creates statutory timeframes in which health insurers must respond to provider appeals of such cancelations, denials, or recoupments. As industry trends, federal policy changes, and financial pressures increase the frequency of disputes between health care providers and commercial health insurers (payors), PA 26-56 seeks to address areas of contention between providers and payors involving the timing and process of recoupment demands and appeals. The changes are as follows: Currently, a managed care organization or preferred provider network is prohibited from canceling, denying, or demanding the return of payment for authorized covered services, due to an administrative or eligibility error, more than 18 months after receiving the clean claim, and Connecticut laws are silent as to the applicable timeline for such cancellations, denials or demands when made by other payor types issuing individual or group health insurance policies. The Act shortens that timeframe to 12 months for managed care organizations and preferred provider networks and also creates an analogous prohibition on any insurer, health care center, fraternal benefit society, hospital service corporation, medical service corporation, or other entity delivering, issuing for delivery, renewing, amending or continuing, an individual or group health insurance policy from canceling, denying, or demanding the return of payment for an authorized covered services due to an administrative or eligibility error, more than 12 months after receiving the clean claim. In the event a provider appeals such a demand from a payor, current law does not specify a modality for the appeal. Under PA 26-56, a payor must establish and offer an electronic appeals process, but can also offer additional methods. This Act requires payors to respond to an appeal and issue a determination within 30 business days of receipt, and establishes that the failure to meet this deadline results in the appeal being construed in the provider’s favor. PA 26-56 clarifies that the existing 30-day advanced notice of payment cancellation requirement must be sent by either certified mail return receipt requested, email to an address specifically designated by the provider, or through a secure electronic provider portal or clearing house used for claims communication. While the changes are limited, they address an area of common contention in the negotiation of commercial health insurance reimbursement agreements and will offer both providers and payors a degree of increased certainty in the timeframes around recoupments and appeals.

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Connecticut Heightens Scrutiny of Private Equity in Healthcare with Law Banning Hospital Sale-Leaseback Agreements and Requiring Private Equity Attestations

On May 27, 2026, Connecticut Governor Ned Lamont signed into law Public Act 26-22, “An Act Concerning Hospital Sale-Leaseback Agreements and Attestations Concerning Lack of Private Equity Control of the Hospital and Control of or Interference with the Professional Judgment and Clinical Decisions of Certain Health Care Providers” (PA 26-22). PA 26-22 prohibits Connecticut hospitals from entering into “sale-leaseback transactions” and requires them to submit annual attestations disclaiming certain private equity interests in or authority over the hospital. First, PA 26-22 prohibits Connecticut hospitals entering into sale-leaseback transactions, which are defined as any transaction where a “hospital enters into an agreement with a person or another entity to sell and lease back hospital-owned real property that constitutes the main campus of a hospital.” For purposes of this prohibition, PA 26-22 defines a hospital’s main campus as the “licensed premises within which the majority of inpatient beds are located.” Accordingly, PA 26-22 restricts the ability of a hospital to enter into a sale-leaseback arrangement involving its campus but does not apply to off-campus hospital-owned locations. For purposes of PA 26-22, a “private equity entity” is defined as “any entity that collects capital investments from individuals or entities and purchases, as a parent company or through another entity that the entity completely or partially owns or controls, a direct or indirect ownership share of a hospital.” Second, PA 26-22 establishes a new attestation requirement requiring hospitals to disclaim private equity involvement in their ownership, governance, and operations. Beginning on February 15, 2027, and annually thereafter, each hospital in Connecticut must submit an attestation to the Commissioner of Public Health’s Office that no private equity entity: Has a controlling interest (meaning “direct or indirect power to direct the management and policies of the main campus of a hospital, whether through ownership of voting securities, contract or other means”) in the hospital. Has ultimate governance control and authority over any hospital asset or activity of the main campus of the hospital, including without limitation any clinical, operational, managerial, financial, or human resources matter. Is permitted to control or direct any procedure or policy that would interfere with professional judgment or clinical decisions of authorized clinicians, including time spent with patients, number of patients seen, time spent on triage or admission evaluations, time periods for patient discharge, clinical decision making including related to observation status or palliative care, diagnostic testing, or coding determinations in the medical record. Failure to comply with the attestation requirement will result in a civil penalty of up to $2,000 per violation. However, PA 26-22 also clarifies that it does not prohibit hospitals or their affiliates from investing in joint ventures or entering into clinical services contracts with physicians, nor is it intended to interfere with a hospital coordinating with its parent health care system. The Act demonstrates a continued focus by Connecticut on private equity business arrangements involving hospitals in the wake of notable bankruptcy and reorganization matters involving private equity-owned health systems in Connecticut and neighboring states. It remains to be seen how the ownership/control attestation and heightened scrutiny provided for by PA 26-22 will impact private equity investment in health care in Connecticut.

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Connecticut Establishes New Process for Hospitals Seeking to Pause or Terminate Service Lines

On May 26, 2026, Connecticut Governor Ned Lamont signed a bill overhauling the state’s Certificate of Need (CON) program which, among other things, eliminates the current CON approval requirement for a hospital to terminate services. A new process for hospitals to provide notice of service suspensions and terminations is part of the State’s budget bill, Public Act No. 26-68 (the “Act”). This new process is highlighted below and will take effect starting July 1, 2027. For our analysis of the Act’s changes to the CON process, please see here.  Current CON Requirement for Hospital Service Terminations Currently, hospitals must obtain CON approval of the termination of a service, which applies where the hospital ceases providing a service for more than 180 days over a two-year period. This CON requirement has led to challenges for the health care organizations due to the current CON decision factors not expressly contemplating terminations, and the fact that “services” is not defined in the CON statutes or regulations. New Process for Hospital Service Line Terminations – Starting July 1, 2027 The Act establishes a new process for hospital service line terminations (including pauses of 90+ days), and in doing so gets rid of the current 180-day termination standard as well as the current requirement to obtain CON approval to terminate a hospital service. Short-Term Service Pauses; Definition of Service Lines Subject to the New Process Under the Act, hospitals are permitted to temporarily pause service lines for up to 90 days without any notice or approval.  Importantly, the Act also specifies that “service line” refers to “a category of inpatient and outpatient services” but does not include services provided by an emergency department. Service Line Termination Notice Requirement If a hospital intends to pause a service line for more than 90 days, or elects to terminate the service line, the hospital must provide 90 days’ advance notice to the following state agencies: The Department of Public Health’s (DPH) CON program; Office of the Attorney General; Department of Social Services; Office of the Healthcare Advocate; and If the termination relates to behavioral health or substance use disorder services, to the Department of Mental Health and Addiction Services and the Behavioral Health Advocate. The service termination notice must include:  A description of the service(s) to be terminated; Utilization rates; Anticipated impact on the primary service area; An account of all community planning that has and will take place; The proposed effective date of the termination, as well as the anticipated resumption date (if applicable for certain pauses of service lines); and Any other information required by the Director of the CON program established under the Act. In the event 90 days’ notice is impracticable due to circumstances outside of the hospital’s control, the hospital is obligated to provide notice as soon as practicable and no later than 14 days following the start of an unanticipated cessation of a service line. Public Hearing Following submission of the notice, the service termination (or 90+ day pause) proposal will be subject to a mandatory public hearing. The hearing will review the impact on the hospital’s primary service area, and plans for ensuring continued access to high-quality affordable health care in that area. The hearing record and any public comments will be provided to the CON panel, consisting of the Commissioners of DPH and DSS and the Secretary of the Office of Policy Management (the “CON Panel”), which it will use to aid in its review of the plan for ensuring access further described below. Service Line Access Plan Following the provision of notice of the termination (or long-term pause) of a service line, a hospital is required to submit a plan for ensuring continued access to the services following the pause or termination of the service (“Access Plan”). The Access Plan must be submitted at least 60 days prior to the effective date of service line termination (or as soon as practicable and within 14 days of the cessation where due to an unplanned event outside of the hospital’s control). The Access Plan must include: Prior service line utilization; The locations and service capacity of alternative sites of the services; Travel times to such alternative sites; A transportation needs assessment and plan for meeting any such needs; A protocol detailing mechanisms to maintain continuity of care for affected patients; and A protocol for providing notice to affected patients in the primary service area of the service line termination (or pause), which includes information on alternative sites, and how affected patients can receive assistance from the hospital to obtain the services and preserve continuity of care. The CON program will then review the Access Plan and determine if it ensures continued access to the service. The CON program will review and provide written recommendations regarding the approval, modification, or imposition of conditions on the Access Plan within ten days. The CON Panel will then hold a meeting regarding the Access Plan within ten days, and the hospital can provide comments on the recommendations at any time prior to the meeting. Within ten days after the meeting, the CON Panel will approve, require modifications, or add conditions to the proposed Access Plan.  The CON Panel’s decision on the Access Plan constitutes a final decision subject to review and procedural rights afforded to contested cases under the Uniform Administrative Procedures Act. The CON program will maintain oversight of the final approved Access Plan, and the Act grants the CON program authority to impose performance improvement plans on hospitals and to seek civil penalties for noncompliance.

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Everything Old is New Again: Connecticut Revamps Certificate of Need (CON) Program under Department of Public Health

On May 2, 2026, the Connecticut Legislature approved the overhaul of the state’s Certificate of Need (CON) program as part of its appropriations bill for the fiscal year ending June 30, 2027, Public Act No. 26-68 (“the Act”). The Act significantly revises all aspects of the CON program and process, including most notably by eliminating the independent Office of Health Strategy (OHS) that had overseen CONs since 2018, and returning oversight for CON largely to the State Department of Public Health (DPH). The Act is the culmination of years of debate over the CON process, and the Governor is expected to sign the Act in the near future.  Various sections of the Act take effect October 1, 2026, with the new CON process fully taking effect July 1, 2027. Below is a summary of the major elements of the new CON process and how they differ from the current process. Creation of CON Panel within DPH The Act establishes a new CON program within DPH (referred to herein as the “CON Program”), which will be overseen by a three-person panel consisting of the respective Commissioners of DPH and the Department of Social Services (DSS), as well as the Secretary of the Office of Policy and Management (OPM) (the “CON Panel”). After July 1, 2027, the Panel’s CON Program responsibilities will notably include: Issuing rulings and final decisions on all CON applications; Issuing civil penalties and cease and desist orders associated with CON applications, CON decisions/settlements, and related CON Program laws and regulations; Approving CON Program policies and procedures, including the promulgation of CON regulations; Reviewing and approving hospital plans for continued access to care during service terminations (in connection with the new process for hospital terminations of service established by the Act, which we reference below and will describe in further detail in a forthcoming post); and Assuming existing obligations of OHS in connection with the review of proposed sales of nonprofit hospitals to for-profit purchasers under Conn. Gen. Stat. § 19a-486a.  The CON Panel will meet monthly to address matters related to CON Program applications and other business, as further described below. Changes to CON Program Definitions and When a CON is Required Importantly, the Act (i) revises certain key defined terms that impact the applicability of the CON Program, and (ii) streamlines certain current CON categories and CON exemptions while reducing instances in which a CON is required.  Among other changes, the Act makes the following updates affecting CON definitions and requirements: Changes of Ownership or Control Subject to CON Review Currently, the defined term intended to capture change of ownership-type transactions requiring CON approval is “transfer of ownership” which refers to a “transfer that impacts or changes the governance or controlling body of a health care facility, institution or large group practice, including, but not limited to, all affiliations, mergers or any sale or transfer of net assets of a health care facility.” Going forward, the defined term is updated to “change of ownership or control” which is more broadly applicable to “any change in the ownership or beneficial ownership or the change of control of an entity, including (A) a corporate merger, (B) an acquisition of one or more entities by direct or indirect purchase in any manner of not less than twenty-five per cent of the assets, equity or voting shares of a health care facility, (C) a transfer of control of a board of directors or governing body, or (D) a real estate sale or lease agreement involving not less than twenty per cent of the total assets of a hospital.” Importantly, this new defined term establishes a 25% threshold for asset / equity / voting interest acquisitions for a transaction that could require CON Program review, as well as certain real estate transactions involving hospitals. Applicability of CON Laws to Hospital Satellites The Act expands the current definition of a “health care facility” subject to CON requirements with respect to a hospital to indicate that the term “hospital” is “including any satellite location” under the hospital’s license, as well as an outpatient surgical facility established by a hospital. This defined term expansion is notable because it potentially brings the closure of a hospital satellite location within the new process for hospital service terminations, but could also be construed to potentially require CON review of the establishment of new hospital satellites. New Process for Terminations Consistent with the new process for hospital service terminations (which will no longer require full CON review and approval as described further below), the Act’s new CON defined terms remove the current definition of a “termination of service” which had referred to “the cessation of any services for a combined total of greater than one hundred eighty days within any consecutive two-year period.” Behavioral Health and Substance Use Disorder Exception The Act notably replaces the longstanding current exception to CON requirements for nonprofit facilities and providers (other than hospitals) holding state contracts for certain services, to now establish an exception to CON requirements for all facilities, institutions, and providers that are nonprofit (or operated by the State) and that solely provide behavioral health or substance use disorder treatment services. CON Exception for 10-Mile Facility Relocations Currently, health care facilities seeking to relocate are required to submit a CON Determination to OHS and demonstrate that the proposed relocation will not impact the patient population or payor mix of the facility. The Act includes a new CON exception, permitting all facility relocations within the same town or within 10 miles of the facility’s current location, as long as the relocation does not result in a substantial change to the facility’s payor mix or patient population. Large Group Practice Notification Process The Act establishes a new mandatory notice process applicable to certain changes of ownership or control of a large group practice that are otherwise carved out from full CON review under the Act (e.g., due to the acquirer being a physician). Under the Act, the acquiring person or entity must give DPH at least 30 days’ advance notice prior to closing of the transaction involving the large group practice, and include in such notice certain information required by DPH (including names, medical specialties, addresses, and any entities providing management services, in connection with the transaction). The Act’s New CON Application Process Application Submission The Act creates an entirely new CON application process, described below: CON applications will need to be submitted on a monthly rolling deadline, with submission dates on the 15th of each month. At least 21 days prior to submission, the applicant(s) must provide the CON Program a notice for posting on its website with a description of the applicant, any known parties, a description of the proposal, and a reference to the applicable law requiring a CON. If the application is not submitted within 90 days of the notice, a new notice must be submitted. Importantly, any person wishing to request party or intervenor status with respect to an application must file notice of such intent, including whether the person seeks a hearing on the application, within 20 days after the applicant’s notice of intent to file is posted on the CON Program’s website. The Panel will appoint a hearing officer to decide if intervenor or party status shall be granted, consistent with the Connecticut Uniform Administrative Procedures Act. The CON applicant will have five days to file an objection to the intervenor and the office must issue a decision within 15 days. This is a significant change to the current process, which allows intervenor and party petitions much later in the process. Application Review and Staff Report Following submission of an application: The CON Program must notify the applicant of whether there is deemed complete status within 15 days of the deadline. If an application is deemed incomplete, the CON Program will provide a list of elements of the application inadequately addressed within five days and permit resubmission of a revised application during the next application window ending on the 15th day, or other subsequent application window. Once deemed complete, the CON Program will review and provide a report on the application and how it meets the new CON factors (described below). This report must be issued at least 10 days prior to any public hearing and in no event later than 90 days after the application is deemed complete. In compiling the report, the CON Program may ask for additional information but is not permitted to do so in a manner that would delay review timelines. The CON Program can supplement the CON application record with additional reports and evidence no later than 75 days after the application is deemed compete, and the CON Program will give the applicant(s) 10 days to respond to such evidence, which will be included in the record. CON Hearings Within 90 days of the application being deemed complete, the CON Program will hold a hearing on all CONs, unless the applicant waives this right. The applicant may waive the right to a hearing within 30 days of the application being deemed complete if the applicant is the only party and no other person or entity has been granted intervenor status. Such waiver will also constitute a waiver of the applicant’s right to appeal a final decision under the CT Administrative Procedures Act; i.e., by waiving the hearing, the CON becomes an “uncontested case” under the Administrative Procedures Act which reduces the applicant’s procedural rights to challenge an unfavorable decision. If a hearing is held, the following post-hearing process will then occur leading to a final decision: Timeline Event 10 days after adjournment of hearing The hearing record closes. If no hearing is held the record will close 10 days after issuance of the report. 60 days after hearing record closes, or if the hearing right is waived, 150 days after the application is deemed complete The hearing officer transmits the hearing record and a proposed final decision to the Panel for review at the Panel’s next monthly meeting. If the proposed final decision imposes conditions, the hearing officer will meet with the applicant five days before transmitting to the Panel. Within 14 days of publication of proposed final decision The applicant may file written briefs and request oral argument on the proposed final decision. Panel’s next monthly meeting following receipt of the proposed final decision The Panel will review the proposed final decision and has the authority to impose any conditions on approval that are permitted by law. By majority vote, the Panel will either approve, modify, remand for further development of the record and consideration at their next meeting, or send to settlement negotiations. Immediately upon a majority vote by the Panel to approve a proposed final decision The approved proposed final decision becomes automatically converted to a final decision. Within 30 days of a vote by the Panel to modify a proposed final decision The proposed final decision shall be modified consistent with the Panel’s modifications and then published as a final decision. At the next monthly meeting of the Panel following a vote to further develop the record or engage in settlement negotiations The Panel reviews and votes upon the updated record or proposed settlement. Once the Panel issues a final decision, it is subject to appeal under the CT Administrative Procedures Act, similar to the current process, and subject to whether the applicant(s) waived the right to a hearing (and thus potentially waived the right to appeal any final decision). CON Review Criteria The Act establishes new CON factors which will govern the Panel’s review of all CON applications. The Panel will determine by a preponderance of evidence standard whether the application demonstrates the proposal is in the public interest. The Panel will specifically consider whether the proposal: Promotes the delivery of high quality care in the applicant’s primary service area; Promotes access to health care services, including for Medicaid beneficiaries, in the primary service area; Promotes the delivery of cost-effective care in the applicant’s primary service area; Promotes the financial stability of the health care system, including whether the proposal is financially feasible to implement and whether the applicant has any prior evidence of financial mismanagement or misconduct; Demonstrates a clear public need; and Would result in the unnecessary duplication of services. The Act thus streamlines the CON review factors (of which there are currently 12, with a number rarely applicable to CON reviews), to focus on access, need, quality, and cost. As is the case under the current law, the Panel may engage a consultant to review the proposal with costs passed onto the applicant capped at $100,000. The applicant will have the right to withdraw any application before incurring consulting fees. Expedited CON Review The Act requires the establishment of an expedited CON review process for certain categories. These categories are: Relocations of more than 10 miles and outside of the current town of operation; Increases of inpatient or outpatient hospital beds; Acquisition of CT, MRI, PET, or PET-CT scanners by any person, physician, provider, or hospital; Increases of two or three operating rooms within a three-year period by an outpatient surgical facility or short-term acute care general hospital; or any other category the DPH commissioner designates in regulations. Requests for expedited review will begin on January 1, 2028. Applications must be submitted under the same deadlines as the standard process, but include the expedited request. The CON Program will inform the applicant within 15 days whether an application qualifies for the expedited process. Notably, the decision of whether to hold a hearing as part of an expedited review becomes permissive at the Panel’s discretion. If an application is deemed eligible for expedited review, a proposed final decision will be issued within 60 days of the application being deemed complete, and the application will be considered at the next monthly meeting of the Panel. If an application is determined not to be eligible for expedited review, the application reverts to the (new) standard CON Program process described above. Enforcement Powers The Act grants authority to the Panel to investigate CON violations, including by administering oaths and taking testimony, subpoenaing witnesses and documents, and issuing civil penalties. As is the case currently, civil penalties may be issued when a person or health care facility negligently undertakes an activity without a required CON approval or fails to comply with a CON decision’s terms or conditions or a panel-approved agreed settlement. Such penalties are also permissible for negligently failing to submit a required notice about changes in ownership or control of a large group practice that is not subject to CON approval or a hospital’s pause of a service for more than 90 days. As under current law, the maximum penalty is $1,000 per day.

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Massachusetts Governor Healey Announces New Department of Insurance Regulations Intended to Streamline Prior Authorization Practices

On January 14, 2026, Massachusetts Governor Maura Healey announced that the Division of Insurance (DOI) will be promulgating updates to its regulations with the intent of streamlining prior authorization practices for health insurance claims. According to the Governor, the DOI regulations “will reduce unnecessary delays and cut administrative burdens to make it easier, cheaper and faster for people to get the medications and care they need,” including by elimination of prior authorization requirements for routine and essential services. The forthcoming regulations are likely to be issued by the DOI in the coming weeks and are expected to include: Elimination of prior authorization requirements for routine and essential services, including for patients with diabetes related to any services, devices or drugs related to the chronic disease; A 24-hour response timeframe for urgent prior authorization requests; Continuity of care requirements for patients switching health plans, including honoring previously existing authorizations when a patient switches insurers; Initiatives to increase transparency and reduce provider burden when determining if a prior authorization is necessary. The announcement also included the establishment of a Health Care Affordability Working Group, composed of industry stakeholders, which will focus on identifying drivers of health care costs and issuing proposals to make health care more affordable in the commonwealth. These DOI regulations are just one of the anticipated legislative and regulatory initiatives in Massachusetts to address health care costs as the “health care industry spent $1.3 billion on administrative costs related to prior authorizations in 2023,” according to the Governor, citing a Council for Affordable Quality Healthcare report. The forthcoming DOI regulations will be important to health care providers that participate in commercial or state administered health plans in Massachusetts and may lead to changes in existing prior authorization processes, including requiring updates to existing provider participation agreements. We will issue an update when the DOI regulations are released.  

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Connecticut Budget Bill Includes Notable Changes to CON Laws

On June 30, 2025 Connecticut Governor Ned Lamont signed a bill implementing the state budget through June 30, 2027, Public Act No. 25-168 (PA-168).  PA-168, among other things, contains changes to the state’s Certificate of Need (CON) program. Termination of Services – Effective from Passage In Connecticut, hospitals generally must obtain CON approval from the Office of Health Strategy (OHS) for a termination of inpatient or outpatient services.  In 2022, the legislature newly defined the term “termination of services” as when services cease for “a period greater than” 180 consecutive days (see our analysis of that legislation here). OHS subsequently sought, on at least one occasion in 2024, to take the position that there had been a termination of services necessitating CON approval where a particular service at a hospital had been closed for more than 180 days cumulatively over the period of a calendar year. The hospital pushed back on OHS’s interpretation of the statute, countering that the definition of that term required the hospital service to be terminated for 180 days consecutively in order to be met (and thus require CON approval). PA-168 changes the definition of “termination of services” such that the term now encompasses the “cessation of services for a combined total of greater than 180 days within any consecutive two-year period.” This change was specifically sought by OHS in its annual legislative proposal, likely in response to its unsuccessful enforcement position taken in 2024, and now puts the onus on hospitals to closely track any service suspensions, interruptions or closures (regardless of the reason) to ensure compliance with CON program requirements. Consideration of Cost and Market Impact Review Documents – Effective October 1, 2025 PA-168 also expressly allows the Health Systems Planning Unit (HSPU) of OHS to take into consideration cost and market impact review (CMIR) reports and comments when deciding CON applications for the transfer of ownership of a hospital. Existing law requires OHS to conduct a CMIR for certain CON applications involving the transfer of ownership of a hospital, where the purchaser is a for profit entity, or the purchaser is a hospital or hospital system that had revenue in excess of $1.5 billion in fiscal year 2013. The CMIR is performed by an independent third-party consultant, with the costs for such work borne by the purchaser of a hospital and subject to a cap of $200,000 per application. Specifically, PA-168 allows the HSPU to consider the following as part of its CON application review: the preliminary CMIR report and the response of the applicant(s) to the preliminary report; the final CMIR report; and any written comments from the parties regarding the reports issued or submitted as part of the review. Additionally, the law provides that OHS cannot place the preliminary CMIR report into the public record until the transacting parties to the CON have had a chance to respond to such preliminary report. PA-168 does not otherwise change the existing CMIR process. Takeaways These changes are the product of a legislative session that robustly debated changes to the CON program. The legislation demonstrates the substantial continued interest in Connecticut in the operations of the state’s CON program, despite the fact that for a second consecutive year the legislature declined to adopt more substantial proposed changes to CON processes. Of note, earlier in the session, Governor Lamont also signed an act establishing an emergency CON process for hospitals in bankruptcy (which we previously analyzed here, a process that has not yet been utilized in the state but is expected to expedite the transfer of ownership of the Prospect Medical hospitals in the state). For summaries of the other healthcare-related provisions of PA-168, please review the Health Law Diagnosis.

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Medicare Telehealth Flexibilities Extended through September 30, 2025

This post is co-authored by Seth Orkand, co-chair of Robinson+Cole’s Government Enforcement and White-Collar Defense Team and Paul Palma, law intern at Robinson+Cole. Paul is not admitted to practice law. On March 14, 2025, as part of a spending bill to avert a federal government shutdown, Congress extended COVID-era telehealth “waivers” applicable to Medicare until September 30, 2025.  These were originally scheduled to end March 31, 2025. This is welcome news for health care organizations who have relied on the flexibility offered by these waivers to extend access to telehealth services for Medicare beneficiaries and other patients nationwide since the COVID-19 pandemic. However, this represents another short-term extension by the government and poses questions on whether all or some of the telehealth flexibilities will be codified into law. As a reminder, a set of key waivers to Medicare telehealth payment restrictions were enacted under the Social Security Act temporarily in connection with COVID-19 pandemic measures. These statutory waivers have now been extended by act of Congress multiple times, and this latest extension will have the following impacts related to telehealth: Telehealth at Home: Medicare patients will continue to be able to receive telehealth services in their homes and in any other location in the country through at least September 30, 2025.  In the absence of this extension, Medicare beneficiaries would have only been permitted to receive telehealth services in certain approved health care facilities in rural locations (outside of metropolitan statistical areas) as of April 1, 2025. Note that the Social Security Act does include a narrow exception that permits telehealth services in the home (or other locations) for patients in specific circumstances approved by law or regulation, including patients being treated for acute stroke symptoms, patients with a substance use disorder diagnosis, or patients with a mental health disorder (but see the additional in-person requirement for mental health telehealth treatment noted below), and patients on home dialysis for related clinical assessments. Audio-Only Telehealth: Telehealth services can continue to be provided via audio-only communications systems. Without the extension, telehealth services would no longer have been available via audio-only systems as of April 1, 2025, and to be reimbursed for telehealth services would require the use of approved interactive telecommunications systems only (which are defined generally to refer to audio/video equipment allowing for two-way real-time interactive communications between the patient and provider, except in narrow exceptions for store-and-forward technology under telemedicine demonstration programs). Telehealth Providers: Medicare patients can continue to receive telehealth services from all types of approved Medicare-enrolled providers (the waiver permits qualified occupational therapists, physical therapists, speech-language pathologists, and audiologists to furnish services via telehealth and be paid by Medicare for doing so). FQHC/RHC Telehealth: Federally qualified health centers (FQHCs) and rural health clinics (RHCs) can continue to provide telehealth services to patients in other locations. Additionally, the legislation extends until October 1, 2025, the effective date of a requirement for reimbursement by Medicare of telehealth services to a Medicare beneficiary for purposes of diagnosis, evaluation, or treatment of a mental health disorder that: the provider must have furnished a Medicare-covered item or service to the beneficiary in-person (without the use of telehealth) within the prior 6 months before furnishing such telehealth services, and the provider must continue to furnish Medicare-covered items or services in-person (without the use of telehealth) to the beneficiary at least once a year following each subsequent telehealth service. The annual in-person follow-up is not required if the provider and beneficiary agree the risks of an in-person service outweigh the benefits. Once required, the foregoing in-person visit requirement could also be fulfilled by another provider of the same specialty in the same group as the provider furnishing the telehealth service if the telehealth provider is not available to do so. Despite this temporary reprieve to sustain current telehealth waivers through September 30, 2025, health care organizations should start preparing now for the potential end of the waivers and additional restrictions on telehealth services as soon as October 1, 2025. Moreover, health care organizations should also be aware that additional flexibilities and waivers tied to the COVID-19 era remain in place but are scheduled to expire at the end of 2025, including DEA tele-prescribing flexibilities previously discussed here.

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Connecticut Establishes Emergency Certificate of Need Process for Hospitals in Bankruptcy

*This post was authored with Paul Palma, law intern at Robinson+Cole. Paul is not admitted to practice law. On March 3, 2025, Connecticut Governor Ned Lamont signed a law establishing a new process for hospitals in bankruptcy to apply for an “emergency certificate of need” (CON) to approve a transfer of ownership. The law, titled  “An Act Concerning An Emergency Certificate Of Need Application Process For Transfers Of Ownership Of Hospitals That Have Filed For Bankruptcy Protection, The Assessment Of Motor Vehicles For Property Taxation, A Property Tax Exemption For Veterans Who Are Permanently And Totally Disabled And Funding Of The Special Education Excess Cost Grant” (the “Act”), was passed by the Connecticut Legislature though its emergency certification process in order to expedite its approval, presumably to allow the law and new process to be available for CON review of the potential sale(s) of Prospect Medical hospitals in Connecticut expected this year. Emergency CON Process Under the Act, the emergency CON process is to be available when “(1) the hospital subject to the transfer of ownership has filed for bankruptcy protection in any court of competent jurisdiction, and (2) a potential purchaser for such hospital has been or is required to be approved by a bankruptcy court.” The Act requires the Office of Health Strategy (OHS) to: Develop an emergency CON application for parties to utilize, and in doing so OHS must “identify any data necessary to analyze the effects of a hospital’s transfer of ownership on health care costs, quality and access in the affected market.” Notably, if the buyer is a for-profit entity, OHS is permitted to require additional information to ensure that the continuing operation of the hospital is in the public interest. Make a “completeness” determination on a submitted application within 3 business days. Once an emergency CON application is deemed complete, OHS may – but is not required to – hold a public hearing within 30 days thereafter, and if a hearing is held OHS must notify the applicant(s) at least 5 days in advance of the hearing date. The Act provides that a public hearing or other proceeding related to review of an emergency CON is not a “contested case” under the state’s Uniform Administrative Procedure Act, which limits the procedural and appeal rights of the applicant(s). The Act also allows OHS to contract with third-party consultants to analyze the effects of the transfer on cost, access, and quality in the community, with the cost borne by the applicant(s) and not to exceed $200,000. Emergency CON Decisions and Conditions The Act requires final decisions on emergency CONs to be issued within 60 days of the application being deemed complete. Importantly, OHS is required to “consider the effect of the hospital’s bankruptcy on the patients and communities served by the hospital and the applicant’s plans to restore financial viability” when issuing the final decision. The Act also permits OHS to “impose any condition on an approval of an emergency” CON, as long as OHS includes its rationale (legal and factual) for imposing the condition and the specific CON criterion that the condition relates to, and that such condition is reasonably tailored in time and scope. The Act also expressly provides that any condition imposed by OHS on the approval of an emergency CON will apply to the applicant(s), including any hospital subject to the transfer of ownership “and any subsidiary or group practice that would otherwise require” a CON under state law that is part of the bankruptcy sale. However, the Act does allow the applicant(s) to request a modification of conditions for good cause, including due to changed circumstances or hardship. Finally, the Act provides that the final decision on an emergency CON, including any conditions imposed by OHS as part of the decision, is not subject to appeal. Takeaways The Act seeks to establish a clear expedited pathway for CON review of hospital (and health system) sales as part of the bankruptcy process.  The specific process, including the form of application, is likely to be rolled out quickly by OHS to be available as part of the resolution of the Prospect Medical bankruptcy process anticipated to occur during 2025. The ultimate efficacy of the process will depend upon the specific data sought as part of the emergency CON process, and on the scope of any conditions imposed by OHS on the sales (which could introduce uncertainty into the bankruptcy sale and approval process), but the establishment of this avenue for review is likely to be welcomed by parties to hospital system bankruptcy actions.

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Trump Administration Issues Executive Order Prioritizing Hospital Price Transparency Enforcement

On February 25, 2025, President Donald Trump issued an Executive Order titled “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information” (the 2025 Order). The 2025 Order directs federal agencies to take various actions to prioritize enforcement of healthcare price transparency requirements for hospitals and health plans “to support a more competitive, innovative, affordable, and higher quality healthcare system.” Price Transparency Rules Background The 2025 Order follows a 2019 Executive Order issued by then-President Trump titled “Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First” (the Price Transparency Order). That 2019 Price Transparency Order resulted in the adoption of regulations commonly called the Hospital Price Transparency Rules. Those Rules, in pertinent part, require hospitals to maintain a consumer-friendly display of pricing information for up to 300 shoppable services and a machine-readable file with negotiated rates for every single service the hospital provides. Read our previous analysis of the 2019 Price Transparency Order here, and our analysis of a 2024 OIG audit of hospital compliance with the Price Transparency Rules here. 2025 Price Transparency Executive Order Requirements The 2025 Order now tasks the Departments of Treasury, Labor, and Health and Human Services with taking “all necessary and appropriate action” to implement and enforce the Hospital Price Transparency Rules because “hospitals and health plans were not adequately held to account when their price transparency data was incomplete or not even posted at all.” Specifically, within 90 days of the 2025 Order, the federal agencies must: (a) require the disclosure of the actual prices of items and services, not estimates;  (b) issue updated guidance or proposed regulatory action ensuring pricing information is standardized and easily comparable across hospitals and health plans; and (c) issue guidance or proposed regulatory action updating enforcement policies designed to ensure compliance with the transparent reporting of complete, accurate, and meaningful data. Notably, the phrase “actual prices of items and services” is not defined in the Order, and the express rebuke of pricing “estimates” appears to run counter to the approach taken under the No Surprises Act regulations (requiring the provision of good faith estimates) and certain state laws that require health care providers to furnish estimates to patients upon request. Whether and to what extent the agencies define these terms in subsequent guidance and/or rulemaking will be essential for health care organizations to monitor. Takeaways for Health Care Organizations Prior to the 2025 Order, the Centers for Medicaid and Medicare Services (CMS) had already issued civil monetary penalties for non-compliance with the Hospital Price Transparency Rules, and the 2025 Order appears intended to ramp up that type of enforcement action. Hospitals, health plans, and providers should expect further guidance and enforcement information from these federal agencies during the 90-day period, which ends May 26, 2025. Regardless, health care organizations would be well-advised to review their price transparency processes and information available for consumers, as well as their policies to prepare for closer scrutiny of pricing disclosure practices. Additional information about the current Hospital Price Transparency Rules is available from CMS here.

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OIG Audit Scrutinizes Hospital Compliance with Price Transparency Rule

*This post was co-authored by Paul Palma, legal intern at Robinson+Cole. Paul is not admitted to practice law. In November 2024, the Department of Health and Human Services Office of Inspector General (OIG) published the results of its audit assessing hospital compliance with the federal Hospital Price Transparency Rule (HPT Rule). OIG determined that 37 out of the 100 hospitals sampled failed to comply with some element of the HPT Rule’s publicly available charges requirements. As a reminder, the HPT Rule requires hospitals to make certain pricing information publicly available and easily accessible on their websites to increase competition and reduce the cost of health care. The HPT Rule is enforced by the Centers for Medicare & Medicaid Services (CMS). Under the HPT Rule, hospitals are obligated to (1) publish a comprehensive machine-readable file that includes a list of standard charges for all items and services and (2) display a list of CMS-specified shoppable services in a consumer-friendly format; this requirement may be met by using an online price estimator tool allowing consumers to obtain free estimates for up to 300 shoppable services. The 37 noncompliant hospitals identified in the audit failed to comply with either one or both of the foregoing requirements. Specifically, OIG found that: “34 hospitals did not comply with one or more of the requirements associated with publishing comprehensive machine-readable files;” and “14 hospitals did not comply with one or more of the requirements associated with displaying shoppable services in a consumer-friendly manner.” Based on the audit results, OIG estimates “that 46% of the 5879 hospitals that were required to comply with the HPT rule did not comply with the requirements to make information on their standard charges available to the public.” In response to its findings, OIG provided CMS with specific recommendations on increasing compliance with the HPT Rule. The report indicated that CMS concurred with all recommendations and proposed corrective actions. The recommendations included the following: Reviewing the specific hospitals identified by OIG as potentially noncompliant and pursuing enforcement measures if CMS determines such hospitals are out of compliance with the HPT Rule; Considering changes proposed by hospitals to clarify aspects of the HPT Rule, such as providing written guidance on the definition of “shoppable services” and developing training and compliance programs tailored for small hospitals; and Continuing to strengthen internal CMS controls, including allocating sufficient internal resources to monitor hospital compliance with the HPT Rule. This OIG audit report and its affirmative direction to CMS to step up enforcement efforts demonstrates that HPT Rule enforcement remains a priority of regulators. According to the report, CMS has already initiated compliance reviews of certain hospitals included in OIG’s sample. Hospitals would, therefore, be well-advised to review the report closely, to assess their current compliance with the HPT Rule, and to consider proactive efforts to ensure continued compliance with the HPT Rule’s requirements. Notably, CMS created an online tool to aid hospitals in determining if their files are compliant with the HPT rule.

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