A New Era of Health Care Noncompetes: Emerging Models and the Future of Labor Mobility

For more than a decade, health care noncompete legislation largely focused on a familiar target: physician restrictive covenants.

That paradigm is rapidly disappearing.

Across the country, legislatures are no longer asking simply whether physician noncompetes should be enforceable. Instead, states are adopting increasingly diverse regulatory frameworks that address workforce mobility, market concentration, patient access, continuity of care, and the role of staffing intermediaries.

The result is a patchwork that can no longer be understood through a simple distinction between states that permit health care noncompetes and states that prohibit them. Instead, several identifiable regulatory models have emerged.

Understanding these models is becoming increasingly important for health care systems, private-equity-backed physician groups, staffing companies, and in-house counsel responsible for managing multistate workforces.

From Physician Noncompetes to Health Care Workforce Regulation

Historically, health care noncompete restrictions focused predominantly on physicians.

Today, however, statutory protections reach a much broader spectrum of health care professionals, including advanced practice registered nurses, physician assistants, behavioral-health providers, social workers, counselors, and some temporary staffing personnel.

Recent enactments in Utah and Virginia illustrate this shift.

For agreements entered into on or after May 6, 2026, Utah prohibits health care noncompetes covering an enumerated group of licensed practitioners whose work requires or involves practice under the license, subject to the statute’s definitions and exceptions.^[1]

Virginia likewise prohibits employers from entering into, enforcing, or threatening to enforce noncompetes against professionals licensed, registered, or certified by specified health regulatory boards, for covenants entered into on or after July 1, 2026.^[2]

The result is a gradual transition from profession-specific regulation toward broader health care-workforce regulation.

Model One: Profession-Based Protection

Several states regulate health care noncompetes by identifying particular professions that warrant special protection.

At the narrower end of the spectrum, some states protect discrete categories of providers.

New Jersey’s psychology regulations treat agreements that limit a client’s freedom to choose a psychologist as unethical, while Iowa voids specified geographic, temporal, and former-patient restraints for covered mental-health professionals.^[3]

Other states focus primarily on physicians.

Arkansas generally makes physician noncompetes void, subject to statutory application rules and exceptions.^[4]

Wyoming likewise makes physician noncompetes void, while allowing a departing physician to disclose the physician’s continuing practice and new professional contact information to certain patients without liability for damages resulting from the disclosure or subsequent treatment.^[5]

Still others protect physicians and additional licensed professions.

Rhode Island prohibits noncompetes involving physicians and advanced practice registered nurses.^[6]

Massachusetts makes physician noncompetes unenforceable and separately bars specified restrictions involving nurses, psychologists, and social workers.^[7]

These statutes reflect a legislative choice to limit competitive restraints for professions closely connected to patient access and continuity of care.

Model Two: Regulated Use

A second group of states permits some health care noncompetes but subjects them to traditional statutory restrictions, on duration, geographic limits, and other terms.

Texas remains a prominent example.

For covered physician covenants, current law requires, among other protections, a buyout, access to specified patient information, no more than a one-year restriction, and a geographic limit of no more than five miles from the physician’s primary practice location; a covenant is not enforceable when the physician is discharged without good cause.^[8]

In West Virginia, a covenant for a physician may not exceed one year or extend more than 30 road miles from the physician’s primary place of practice.^[9]

Pennsylvania’s Fair Contracting for Health Care Practitioners Act generally voids covered noncompetes, but permits a restriction of one year or less when a practitioner voluntarily terminates employment.^[10]

The Act also imposes patient-notification duties when a practitioner departs.^[11]

These statutes preserve some employer protections while prescribing limits tied to mobility and patient access.

Model Three: Conditional Restrictions

Other states make enforceability depend on specific policy conditions.

The District of Columbia generally prohibits noncompetes but preserves a limited exception for highly compensated employees, which includes medical specialists whose compensation satisfies the statutory requirements (currently $270,274).^[12]

Maryland regulates health care noncompetes through multiple layers of statutory restrictions: the statute is triggered only when a practitioner is licensed under the Health Occupations Article, provides direct patient care, and falls within the statutory compensation threshold; once triggered, it imposes limits on the duration, geographic scope, and other terms of the restriction.^[13]

Other statutes focus on employer identity.

Indiana prohibits hospitals, hospital systems, parent companies, affiliated managers, and specified hospital-related entities from entering into covered physician noncompetes for agreements originally entered into on or after July 1, 2025.^[14]

Still others focus on market concentration or public-access programs.

Florida makes certain physician restrictive covenants void when one entity employs or contracts with all physicians practicing the same specialty in a county, subject to the statute’s definitions and exceptions.^[15]

Nevada separately makes void a noncompete that restricts a physician from practicing medicine after the physician’s employment is terminated if the physician was employed as part of a federal J-1 visa waiver program.^[16]

These states are not rejecting restrictive covenants outright. Instead, they are attempting to identify circumstances where enforcement threatens broader health care policy goals.

Three Emerging Trends

Expansion Beyond Physicians

The most obvious trend is expansion beyond physicians. Recent legislation increasingly covers nurses, physician assistants, behavioral-health providers, counselors, psychologists, social workers, and other licensed professionals. The shift suggests legislative concern about health care labor shortages generally rather than physician shortages specifically.

Patient Choice as an Independent Policy Objective

A second trend involves patient access and continuity of care. Increasingly, states are separating patient communication rights from noncompete enforceability. Even where some restrictive covenants remain permissible, legislatures often require departing providers to maintain the ability to communicate with patients and preserve continuity of care. For example, Pennsylvania requires specified patient notice after a practitioner’s departure, while Utah’s statute excludes from certain health care worker nonsolicitation agreements communications concerning the practitioner’s departure or new practice location.^[17]

Growing Scrutiny of Staffing Intermediaries

Perhaps the least discussed trend involves health care staffing agencies and labor platforms. Several states[18] have begun restricting noncompetes imposed by temporary staffing firms, health care employment agencies, and health care technology platforms. These statutes recognize that health care labor increasingly flows through intermediaries that did not exist when many traditional physician-noncompete statutes were enacted. As staffing shortages persist nationwide, legislative attention to these intermediaries is likely to intensify.

What Comes Next?

The future of health care noncompete regulation is unlikely to consist exclusively of outright bans. Instead, the more significant trend may be the proliferation of targeted statutory regimes designed to address specific health care-policy concerns.

Some legislatures will continue focusing on physician mobility. Others will prioritize continuity of care, workforce retention, rural health care access, staffing shortages, or market concentration. What unites these efforts is a growing view that health care labor markets differ from ordinary labor markets and therefore warrant specialized regulation.

For health care employers operating across state lines, that means compliance can no longer be managed through a single restrictive-covenant template. The question is no longer whether a state permits health care noncompetes. Increasingly, the question is which regulatory model the state has adopted and what policy objective that model is designed to advance.

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^[1]Utah Code Ann. §§ 34-51-102, 34-51-202

^[2]Va. Code Ann. § 40.1-28.7:8

^[3]N.J. Admin. Code § 13:42-10.16.; Iowa Code § 147.164.

^[4]Ark. Code Ann. § 4-75-101.

^[5]Wyo. Stat. Ann. § 1-23-108.

^[6]5 R.I. Gen. Laws §§ 5-37-33, 5-34-50.

^[7]Mass. Gen. Laws ch. 112, §§ 12X, 74D, 129B, 135C.

^[8]Tex. Bus. & Com. Code Ann. § 15.50(b)-(c).

^[9]W. Va. Code § 47-11E-2.

^[10]35 Pa. Cons. Stat. § 10324(b).

^[11]35 Pa. Cons. Stat. § 10325.

^[12]D.C. Code §§ 32-581.01 to 32-581.03.

^[13]Md. Code Ann., Lab. & Empl. § 3-716.

^[14]Ind. Code §§ 25-22.5-5.5-1 to 25-22.5-5.5-2.5.

^[15]Fla. Stat. § 542.336.

^[16]Nev. Rev. Stat. § 439A.175(2)(b)(1).

^[17]35 Pa. Cons. Stat. § 10325.; Utah Code §§ 34-51-102, 34-51-202, 34-51-203.

[18] 225 Ill. Comp. Stat. 510/14(g).; Iowa Code § 135Q.1-3.; Ky. Rev. Stat. § 216.724.; L.B. 921.