Washington Attorney General Nick Brown sued DaVita and Fresenius Medical Care Nov. 10, alleging the state’s two largest dialysis providers make their medical directors sign illegal noncompete agreements, according to a news release from the attorney general’s office.
The complaint was filed in Thurston County Superior Court. It asks the court to void the agreements under Washington’s 2019 Noncompetition Covenants Act and to impose penalties for each violation. The state also alleges violations of the federal Consumer Protection Act.
“These giant, for-profit companies require doctors to sign noncompete agreements that violate Washington state law,” Mr. Brown said in the release.
Medical directors at dialysis centers are part-time nephrologists. The Seattle Times reported that the state says they earn far below the 2026 independent contractor threshold of a little over $317,000. The lawsuit says the agreements bar them from working at nearby competitors, can restrict home dialysis care and can extend to entire physician practices.
The state alleges the noncompetes help the companies maintain monopolies in parts of Washington. According to the Times, DaVita or Fresenius is the only in-center option in Clark, Lewis, Spokane and Thurston counties, among others.
DaVita operates 51 dialysis centers in Washington, and Fresenius runs 29. About 9,000 Washington residents receive dialysis.
A DaVita spokesperson told the Times Nov. 10 that the lawsuit gives a “fundamentally distorted” picture of longstanding arrangements with independent physician practices. The company echoed this sentiment in a statement shared with Becker’s, adding that the company remains “in active discussions with the Federal Trade Commission regarding these arrangements and will continue to vigorously defend both their lawfulness and the critical role physicians play in caring for people with kidney failure.”
A Fresenius spokesperson told Becker’s in a statement that it also holds “longstanding partnerships with physicians and physician practices across the United States” and that its “contracting with these groups who serve as Medical Directors in our facilities complies with the law. Medical directors are critical to our provision of high-quality care to our patients and we value our relationships with them.”
The FTC began investigating the companies’ noncompetes in 2024 but has not released findings. Washington’s ban on all noncompete agreements takes effect June 30, 2027.
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