Proposed legislation from the New York State Executive Budget for 2024 includes significant changes to the state’s regulatory approach and authority over healthcare transactions. New York is following a trend on the state level regarding concern over the consolidation of the healthcare marketplace and investor-backed practices and how such transactions should be reviewed. Such proposal follows states like California, Oregon, and Washington. The proposal creates a new statutory article to review “material transactions” and has made changes to the certificate of need process for new and existing entities.