The Lobby · Intelligence briefing

The Federation of American Hospitals

The for-profit hospital lobby: nine executives, five retained firms, one coalition, and the ban on physician-owned hospitals they keep in place.

Record as of November 6, 2026

The board →The eight pillars →

$3.57M

Federal lobbying, 2025 (Senate filings)

$1.91M

Lobbying through Sept. 30, 2026

$825K

FEDPAC gifts to candidates and committees, 2025-26

$99.6M

Spent by the coalition FAH co-founded, 2018 to 2024

01 · Threat assessment

Where FAH stands on the eight fights

FAH's documented position on the eight policy areas that decide whether physician-owned hospitals and independent physicians can compete.

Pillar	FAH position	Threat
01 · CON Laws	Certificate of need laws make a new hospital or surgery center ask the state for permission to exist. Incumbents get to object. In 2026, 25 states changed their CON laws and three repealed whole categories. FAH stayed out of it.	Low
02 · Hospital Consolidation	Every merger that closes is one fewer buyer for a physician's services and one more employer that can bind physicians with a noncompete. FAH's 2025 filings pushed on both ends: less merger scrutiny, more noncompete protection. In 2026 it got the merger form vacated, and the FTC has not sued to block a hospital merger in two years.	Moderate
03 · 340B Drug Pricing	The 340B program lets tax-exempt hospitals buy drugs at a discount and bill Medicare and commercial payers at full price. For-profit hospitals cannot join, so FAH has no stake in defending it. In 2026 CMS cut Medicare payment for 340B drugs to acquisition cost minus 28%, with FAH's support.	Low
04 · No Surprises Act / IDR	The No Surprises Act sent out-of-network pay disputes to arbitration. Insurers built the benchmark, the qualifying payment amount, from contracts that often never covered the service. Physicians have won most disputes anyway. In 2026 the courts and CMS fixed two of the worst mechanics, and FAH cheered both.	Low
05 · Physician-Owned Hospital Ban	Section 6001 of the Affordable Care Act froze physician-owned hospitals in place on March 23, 2010. No new ones can bill Medicare and the old ones cannot add beds. Chip Kahn said the ban would not exist without the Federation. Sixteen years on, FAH is still the guard at the door.	Critical
06 · Site-Neutral Payments	Medicare pays a hospital outpatient department more than a physician office for the same visit, scan or infusion. The gap is why hospitals buy practices and why an independent office cannot match a hospital's bid for a physician. CMS has now closed it for drug administration and for imaging. FAH fought both.	High
07 · Scope of Practice	Scope of practice is decided in state legislatures, one profession at a time. The for-profit chains that staff emergency rooms and clinics with advanced practice nurses fight those battles through state associations. FAH itself is silent. Its only word on physicians in 2025 was that they are fair subjects for noncompetes.	Low
08 · Price Transparency	FAH sued to stop hospital price disclosure in 2019 and lost twice. In 2025 it asked CMS for regulatory stability. In 2026, with four transparency bills moving through committee, FAH's statements pushed every new duty onto insurers and called added hospital reporting duplicative. The actual-price data an independent practice needs to compete stays patchy.	Moderate

02 · The board

Who runs the for-profit hospital lobby

Elected October 14, 2026 for calendar 2027. Dill is also Secretary. Two seats changed hands mid-2026: Ardent's Marty Bonick, the 2026 chair-elect, left Ardent on June 2 and his successor Dave Caspers took the seat. ScionHealth's Rob Jay moved to executive chairman on June 10 and new CEO Doug Shirley took his.

Chair

Sam Hazen

HCA Healthcare

Chair-elect

Saum Sutaria, MD

Tenet Healthcare

Immediate past chair

David Dill

Lifepoint Health

Treasurer

Mark Tarr

Encompass Health

Chair, 2027

Sam Hazen

The $75 Billion Chairman

Chief Executive Officer, HCA Healthcare

$75.6B

HCA revenue, 2025

$26.5M

Hazen pay, 2025

4 red flags →

Chair-Elect, 2027

Saum Sutaria, MD

The $43 Million Chair-Elect

Chairman and Chief Executive Officer, Tenet Healthcare

$43.1M

Sutaria pay, 2025

711:1

CEO-to-median-worker pay ratio, 2025

4 red flags →

Immediate Past Chair and Secretary, 2027

David Dill

Apollo's Chairman

Chairman and Chief Executive Officer, Lifepoint Health

97%

Apollo stake in Lifepoint (Senate Budget Committee, 2025)

$9.2M

Annual management fees to Apollo (2025 report)

4 red flags →

Treasurer, 2027

Mark Tarr

The Medicare Treasurer

President and Chief Executive Officer, Encompass Health

82%

Revenue from Medicare and Medicare Advantage, 2025

$10.3M

Tarr pay, 2025

3 red flags →

Director, 2027

Marc Miller

The Heir With 88.9% of the Vote

Chief Executive Officer and President, Universal Health Services

88.9%

Voting power held by Alan Miller, 2026 proxy

$122M

False Claims Act settlement, 2020

4 red flags →

Director, 2027

Kevin Hammons

The CFO Who Sells Hospitals

President and Chief Executive Officer, Community Health Systems

Hospitals at Oct. 28, 2026, down from 69

$9.6B

Total debt, Sept. 30, 2026

4 red flags →

Director, 2027

Prem Reddy, MD

The Founder Who Paid Personally

Founder, Chairman and Chief Executive Officer, Prime Healthcare

Hospitals in 15 states, 2026

$103.75M

False Claims Act settlements, 2018 to 2021

4 red flags →

Director, 2027

Dave Caspers

The Retailer Running Ardent

President and Chief Executive Officer, Ardent Health

5 months

As CEO, at Nov. 6, 2026

54.0%

EGI-AM control stake, 2026 proxy

4 red flags →

Director, 2027

Doug Shirley

The CFO Holding the Lease

Chief Executive Officer, ScionHealth

Caa2

Moody's rating, with a limited default marker, Jan. 2025

Hospitals closed in 2025

4 red flags →

03 · The machine

Lobbying, PAC and dark money

FAH reported $3.57 million of federal lobbying in 2025, its highest year since 2019, and $1.91 million through the third quarter of 2026. Four in-house lobbyists are registered, including the CEO. Five outside firms are on retainer in 2026. Three others were dropped at the turn of the year, and BGR Government Affairs was added in January. The figures are FAH's own quarterly Senate filings, which already include what it pays the firms.

Lobbying →PAC →

04 · Since April 2026

What has changed

April 28, 2026Statement after the House Ways and Means hearing on health systems: there is no replacement for a local hospital when you need it most. source
May 7, 2026Elizabeth Schwartz hired from Merck as Senior Vice President and Head of Government Relations. source
May 8, 2026FAH rebuts a Families USA post on corporate hospital pricing as not a serious analysis of affordability. source
May 28, 2026Statement welcoming the No Surprises Act IDR operations final rule. source
June 2, 2026Board change: 2026 chair-elect Marty Bonick steps down at Ardent; Dave Caspers becomes CEO and later takes the FAH seat. source
June 10, 2026Board change: ScionHealth names Doug Shirley CEO; Rob Jay moves to executive chairman and off the FAH board. source
June 10, 2026Statement for the House Energy and Commerce transparency hearing: patients' costs are dictated primarily by insurers' benefit design. source
June 17, 2026FAH joins AHA, the Children's Hospital Association and AAMC on a Fifth Circuit amicus brief backing Texas. The case concerns CMS's reading of the Medicaid hold-harmless rules for state hospital taxes. source
June 25, 2026Statement on the House subcommittee price transparency markup: duplicative and impractical hospital reporting requirements will not help patients. source
July 2, 2026Statement on the CY2027 outpatient proposed rule objecting to accelerated 340B recoupment. source
July 15, 2026Statement on the Ways and Means markup praising Medicare Advantage transparency measures. source
July 21, 2026Statement on the Energy and Commerce markup: transparency works when it produces meaningful information for patients, not just more data. source
July 31, 2026Statement on the FY2027 inpatient final rule: adequate Medicare payments become even more critical as uncompensated care grows. source
August 31, 2026CY2027 outpatient comment letter: supports the 340B cut to acquisition cost; opposes the imaging site-neutral cut and the faster recoupment. source
September 22, 2026Statement on CMS Marketplace anti-fraud actions: Americans are being priced out of health insurance and losing coverage. source
October 7, 2026Paul Eiting hired from the Blue Cross Blue Shield Association as Vice President, Policy. source
October 14, 20262027 board elected: Hazen chair, Sutaria chair-elect, Dill past chair and secretary, Tarr treasurer; directors Caspers, Hammons, Miller, Reddy, Shirley. source
October 20, 2026Q3 2026 lobbying report: $760,000, the highest quarter of 2026; four in-house lobbyists. source
November 4, 2026PAHCF, the coalition FAH co-founded, issues a post-election statement that Medicare for All and the public option are not the answer. source
November 4, 2026CMS finalizes the CY2027 outpatient rule over FAH's objections on imaging site-neutral payment and the 2% recoupment. source

05 · Bottom line

The Federation of American Hospitals is nine chief executives and $3.6 million a year in lobbying. Beside it sits a dark-money coalition that has spent $99.6 million since 2018. Its board runs more than 700 hospitals and carries more than $3 billion in federal fraud settlements. In 2025 and 2026 it fought the two reforms that matter most to an independent physician: site-neutral payment and the right to own a hospital. Chip Kahn said the physician-owned hospital ban would not exist without the Federation. Sixteen years in, four repeal bills sit in committee and the Federation's new CEO came from the whip's office.

Sources