The Federal Trade Commission has intensified its focus on healthcare-related regulation in accordance with President Donald Trump’s February 2025 executive order aimed at creating a “more competitive, innovative, affordable, and higher quality healthcare system.”
Here are three recent moves by the FTC that ASC leaders should know:
1. New pressure to repeal certificate-of-need laws: CON laws — while initially designed to prevent duplicate healthcare services from being developed in the same geographic area — have become one of the most contentious policy discussions in the ASC space.
In April the FTC warned lawmakers in Tennessee that the state’s application to the federal Rural Health Transformation program could be at risk if they did not accelerate their repeal of CON laws. As Tennessee lawmakers were working to repeal the state’s CON, it was also working to repeal Johnson, Tenn.-based Ballad Health’s Certificate of Public Advantage. As originally written, the bills would have seen Ballad’s COPA expire on June 30, 2028, and the state’s CON repeal would not take effect until July 1, 2030.
The Tennessee Legislature ultimately reworked the bills. Governor Bill Lee signed legislation eliminating CON requirements for new acute care hospitals, satellite emergency departments and cardiac catheterization services May 6. CON requirements statewide will expire July 1, 2030.
2. FTC launches a new task force. The new healthcare task force, introduced in March, aims to take a more unified approach to investigating anticompetitive behavior, protecting consumers and identifying emerging risks in healthcare markets. It will:
- Lead targeted enforcement and advocacy efforts;
- Develop agencywide strategies for investigations;
- Proactively identify legal opportunities to influence cases through amicus briefs and statements of interest;
- Identify new areas of concern across healthcare.
Healthcare accounts for about 18% of the U.S. economy, yet many patients continue to face high costs, limited access and affordability challenges, Mr. Ferguson said in a March 20 memo. He cited consolidation and anticompetitive practices as key drivers of higher prices, reduced care quality and stifled innovation.
3. FTC reaches preliminary settlement with U.S. Anesthesia Partners: The commission reached an agreement in principle with USAP over allegations brought against the company in 2023, claiming that it violated antitrust laws by engaging in a scheme to consolidate anesthesia services in Texas.
The years-long case against USAP and its private equity backers Welsh, Carson, Anderson & Stowe surrounds claims that USAP executed a roll-up scheme, buying up almost every large anesthesia practice in Texas to create a single dominant provider that could demand higher prices. USAP and Welsh Carson then allegedly drove up prices further through billing agreements with remaining independent practices. USAP later allegedly sidelined a competitor by agreeing to a deal to keep it out of USAP’s territory, according to the original complaint.
The terms of the confidential agreement would “restore a competitive market structure and will be consistent with longstanding FTC settlement best practices” should they be executed in full by USAP.
USAP physician and Board Chairman Scott Holliday, DO, underscored USAP’s dedication to finding a resolution to the case that minimizes disruptions to patient care and avoids exacerbating uncertainties in an April 23 news release.
Greater FTC scrutiny of roll-ups — especially in anesthesia — could limit aggressive consolidation strategies and reshape contracting dynamics for ASCs. Leaders may see more competition among anesthesia providers, but also increased regulatory oversight on partnerships and pricing arrangements.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.