This legislation, known as the "Health Over Wealth Act," seeks to amend the Public Health Service Act to impose new requirements on for-profit corporations and private equity funds involved in owning healthcare systems. Its primary goal is to enhance transparency and accountability within the healthcare sector, particularly concerning the financial and operational practices of these entities. The bill mandates that the Secretary of Health and Human Services establish a comprehensive reporting system for "covered firms," which are for-profit corporations owning healthcare entities. These reports require detailed financial information, including debt levels, asset values, fees collected, and political spending, with even more extensive data required from firms controlled by private equity funds. This information will be made publicly available, audited periodically, and used to generate annual reports to Congress on trends and the impact of ownership types on healthcare access, quality, and patient safety. Furthermore, the bill introduces mechanisms for risk mitigation and accountability. For private equity-controlled firms, it may require establishing escrow accounts to cover operating and capital expenditures for at least five years, especially in cases of facility closure or service reduction. It also prohibits healthcare entities from entering into real estate investment trust (REIT) agreements that would weaken their financial status or endanger public health, requiring Secretarial review of such transactions. A significant provision is the requirement for private equity firms to obtain licenses from the Secretary to invest in or purchase healthcare entities. These licenses can be denied or revoked if the firm fails to comply with the bill's provisions, engages in practices like price gouging or understaffing , or otherwise negatively impacts healthcare access or quality. Revocation would necessitate divestment from healthcare investments, and civil monetary penalties can be imposed for violations. The bill also establishes a task force, chaired by the Secretary of Health and Human Services, to monitor changes in the healthcare marketplace and address the role of private equity and consolidation. This task force will identify best practices, emerging trends, and develop legislative recommendations to preserve and expand healthcare quality, safety, and access. It also grants the Secretary authority to impose a moratorium on private equity acquisitions if abuses like price gouging or access barriers are identified. Additional provisions include maintaining a corporate accountability data collection program for non-compliant entities, with information furnished to the National Practitioner Data Bank. It grants both state and federal authorities enforcement powers, including civil monetary penalties. The bill also directs research into the impact of for-profit and private equity investment on various aspects of healthcare, such as costs, access, and worker conditions. Beyond the Public Health Service Act, the bill amends the Investment Company Act of 1940 to make it unlawful for registered investment companies to engage in practices that would strip assets from healthcare entities or undermine healthcare quality, safety, or access. It also modifies bankruptcy law to prioritize withdrawal liability claims and requires courts to consider regional healthcare access, quality, and staff retention when confirming bankruptcy plans for healthcare businesses. Finally, the legislation imposes new requirements on hospitals regarding the discontinuation of services or closure. Hospitals must provide advance notification, prohibit the discontinuation of essential services during a notification period unless there's a clear harm to patients, and submit mitigation plans if essential services are impacted. These plans are subject to public comment and review, and the Secretary can develop alternative mitigation plans to ensure continued access to essential services, with penalties for non-compliance.