Enforcement runs through two channels: a provider’s own right to sue in state court, and a public ownership register that begins filling in March 2027.

July 30, 2026

Vermont has restricted what financial sponsors may control inside health care businesses, and the operative language reaches well beyond the private-fund sector the measure targets.

Act 133, signed by Governor Phil Scott on June 15 and effective July 1, adds a new chapter to Vermont’s health care title. It does not prohibit fund ownership of providers or facilities. It instead removes a defined set of clinical and business decisions from investor authority, and requires facilities and management services organizations to disclose who stands behind them.

Where the Definitions Land

The definitions do most of the work. A hedge fund, for purposes of the chapter, is a pool of funds managed by investors to earn a return, without regard to the strategies used, and expressly includes pools managed or controlled by private limited partnerships. Two exclusions follow: capital providers who contribute to a fund but take no part in managing the fund, its assets, or any change in its control; and entities that solely provide or manage debt financing secured in whole or in part by the assets of a health care facility, a category the statute illustrates with banks, credit unions, commercial real estate lenders, bond underwriters and trustees.

The word solely carries weight. That exclusion is drawn around pure credit exposure, and it sits only in the hedge fund definition; the companion definition of a private equity group has no lender exclusion, only the same passive-contributor carve-out. Nothing in the chapter turns on a vehicle’s registration status.

What Must Stay With Licensees

A covered fund involved in any manner with a Vermont facility, as an investor in it or in its assets, may not interfere with provider judgment on diagnostic testing, referrals and consultations, patient care plans and treatment options, or how many patients a provider sees and how many hours a provider works.

A second list bars covered funds from exercising control over, or being delegated power to set:

• clinical standards and policies, including clinical staffing levels
• the content of patient medical records
• hiring and firing decisions made on clinical competency grounds
• the parameters for contracting with third-party payers
• the prices charged for a provider’s services
• coding and billing of diagnoses and procedures
• selection of medical equipment and supplies

The reach extends to paper: a covered fund, or an entity it controls, may not enter an agreement enabling any of that interference or control, and organizational form is expressly irrelevant. Management agreements, delegated-authority provisions and reserved-powers schedules are the exposure surface, not cap tables alone.

Nonclinical work remains available. Unlicensed parties may provide management, administrative and business services and consult on the listed matters, provided a licensed provider retains ultimate responsibility or approval and the services stop short of de facto control affecting clinical decisions or care quality.

A Public Ownership Register

Every facility and management services organization must file with the Green Mountain Care Board by March 1, 2027, either a disclosure report or an attestation of no private equity or hedge fund interest, measured as of June 1, 2026. Reports must identify holders of ownership or investment interests, controlling interests and significant equity investors, supply an organizational chart covering affiliates and subsidiaries, and include the latest fiscal year’s profit and loss statement and balance sheet. Afterward, any new or modified fund interest triggers a fresh filing.

The five percent equity threshold is only one of three routes to an ownership or investment interest. The other two carry no percentage floor: interests held by investors engaged in raising or returning capital who invest in, develop or dispose of specified assets, and interests held by pooled funds employing investment strategies of any kind to earn a return. A significant equity investor separately captures any private equity group holding a direct or indirect interest in a facility or management services organization, any holder of more than ten percent of a provider or provider organization, and any party controlling or operating substantially all the property of such an entity under a lease, management or operating agreement.

Nursing homes, health care staffing companies, federally qualified health centers and telehealth-only operators are exempt from reporting. Filings are public with one notable exception: the financial statements stay confidential, shared only with the Office of the Health Care Advocate. The Board posts its first biennial summary by July 1, 2027.

Enforcement

An aggrieved provider may sue in Superior Court for equitable relief, actual damages, costs and fees. Knowing failure to report draws up to fifty dollars per day, capped at ten thousand annually, and each material misrepresentation up to twenty-five thousand, collectible by the Attorney General.