Q1 2026 Healthcare Antitrust and Competition Update

The healthcare sector accounts for an increasingly significant component of the U.S. economy. Healthcare spending constitutes 18.0 percent of U.S. Gross Domestic Product and continues to outpace overall economic growth. Healthcare affordability also remains a central political issue, as seen in the Trump administration’s Great Healthcare Plan unveiled on January 15, 2026, a policy proposal to lower drug prices and insurance premiums. Against this economic and political backdrop, healthcare remained a major focus of the Federal Trade Commission (“FTC”) and the Department of Justice’s Antitrust Division (“DOJ”) in the first three months of 2026, despite leadership changes, including the resignation of the head of the Antitrust Division, Assistant Attorney General (“AAG”) Gail Slater. The agencies pursued a wide range of healthcare-related enforcement actions, including merger challenges, civil lawsuits, and criminal prosecutions. Significant developments also occurred in private antitrust litigation, including actions involving algorithmic pricing, weight loss drugs, and group purchasing organizations. This activity appears primed to continue into the remainder of 2026, leaving antitrust compliance a critical topic for the healthcare sector.

I. Policy Initiatives

• FTC Announces Creation of Healthcare Task Force

  The FTC signaled that it would prioritize healthcare in its enforcement and advocacy agenda through the creation of a Healthcare Task Force (the “Task Force”) announced by Chairman Andrew N. Ferguson on March 20, 2026. In a memorandum, Chairman Ferguson directed the FTC’s Bureau of Competition, Bureau of Consumer Protection, Bureau of Economics, Office of Policy Planning, and Office of Technology to “take a coordinated, integrated approach to healthcare enforcement and advocacy” through the Task Force. The memorandum also stated that the Task Force would seek to expand its membership to other federal agencies, including DOJ and the Department of Health and Human Services (“HHS”).

  Chairman Ferguson explained that the Task Force was formed to address “[c]onsolidation and anticompetitive conduct” that had “distorted the anticompetitive landscape in many healthcare markets,” leading to “higher prices, decreased quality, less access and transparency, and stifled innovation.” Chairman Ferguson criticized “[a]nticompetitive regulations” affecting healthcare, in line with DOJ’s advocacy efforts under the Trump administration to eliminate regulations that “undermine free market competition.” Intended actions of the Task Force include leading targeted enforcement and advocacy initiatives, devising coordinated investigation strategies, identifying amicus and statement of interest opportunities, and evaluating emerging issues in the healthcare sector. However, the Task Force announcement and memorandum provide little detail on concrete actions the Task Force may take or specific issues the Task Force may investigate.

• Acting Assistant Attorney General Places Focus on Healthcare Affordability

  DOJ also signaled that it would continue to prioritize enforcement in the healthcare sector. On March 23, 2026, Acting AAG Omeed A. Assefi delivered public remarks on a “policy vision” for “America First antitrust at DOJ.” Assefi provided the example of an April 2025 wage fixing conviction of a home healthcare staffing agency CEO as an example of DOJ refocusing on pursuing incarceration over fines in criminal antitrust cases. Moreover, in regard to civil antitrust enforcement, Assefi stated that “[f]ighting for lower costs and more choices in healthcare is exactly the kind of kitchen table priority we should be pursuing,” echoing the Trump administration’s broader healthcare affordability policy agenda. Assefi also discussed plans for filing additional civil enforcement actions, including “several important cases in the pipeline.”

II. Enforcement Actions

• Merger Enforcement Actions

  In the first quarter of 2026, the FTC obtained a consent decree requiring divestitures in an acquisition of residential care facilities for individuals with intellectual and developmental disabilities, obtained a preliminary injunction blocking the acquisition of a company developing a heart implant device, and triggered the termination of a merger between laser eye surgery system manufacturers amidst an investigation.

  • FTC Obtains Consent Order in Residential Care Facility Acquisition

    The FTC announced on January 30, 2026, that it had obtained a proposed consent order to resolve antitrust concerns relating to Sevita Health’s (“Sevita”) $835 million acquisition of BrightSpring Health Services, Inc.’s (“BrightSpring”) community living business. According to the FTC’s complaint, the transaction would combine the two largest national providers of residential services to individuals with intellectual and developmental disabilities (“IDD services”). Although the parties did not “primarily compete on price,” since Medicaid is the “predominant payer” for IDD services, the FTC alleged that the transaction could result in harms to “non-price dimensions” of IDD services. In particular, the FTC alleged that the transaction could harm the quality of facilities, staffing levels, training, care standards, safety protocols, and individual services, and could have curtailed families’ ability to choose facilities “aligned with their particular needs and preferences.” Further, the FTC focused on geographic markets consisting of core-based statistical areas (“CBSAs”) centered on individual cities, because recipients of IDD services “prefer to live near their family and friends.”

    The proposed consent order requires Sevita to divest 128 intermediate care facilities (“ICFs”), 15 day program facilities, and one office location. These facilities are located in five CBSAs in Indiana, one CBSA in Louisiana, and four CBSAs in Texas. Dungarvin Group, an existing operator of ICFs, will acquire the facilities. The proposed consent order provides Sevita with 10 days after closing to complete the divestitures. This provision continues the current FTC leadership’s break from a historical preference for the parties to effectuate any remedies pre-closing. Another noteworthy aspect of the proposed consent order is the inclusion of a prior notice provision, which requires Sevita to provide advance written notification to the FTC before acquiring ICFs in specified locations for a period of ten years. This provision continues the FTC’s departure under the Trump administration from its 2021 policy of mandating prior approval provisions in consent orders. Prior notice provisions are significantly less burdensome than prior approval provisions, which require the merging parties to obtain the FTC’s affirmative consent before closing a subsequent transaction.

  • FTC Obtains Preliminary Injunction Blocking Heart Implant Deal

    On January 9, 2026, a federal district court granted the FTC’s request for a preliminary injunction blocking Edwards Lifesciences Corp.’s (“Edwards”) $945 million acquisition of JenaValve Technology, Inc. (“JenaValve”). The same day, Edwards announced that it was abandoning the transaction. In 2024, Edwards executed agreements to acquire JenaValve and JC Medical, Inc. (“JC Medical”), which were both engaged in bringing transcatheter aortic valve replacement devices (“TAVR-AR devices”) to market in the United States. These devices treat a condition called aortic regurgitation, where blood leaks backward into the left ventricle of the heart. Edwards closed its acquisition of JC Medical in July 2024, leaving JenaValve as the only other company with ongoing clinical trials in the United States for a TAVR-AR device.

    The FTC sued to block Edwards’s acquisition of JenaValve on August 6, 2025. In its complaint, the FTC alleged that the acquisition would give Edwards a monopoly in TAVR-AR devices and would reduce incentives to accelerate the development of these devices. Further, the FTC alleged that the transaction could result in reduced innovation, diminished product quality, and potentially higher prices. Following a six-day trial in November 2025, the U.S. District Court for the District of Columbia issued a preliminary injunction blocking Edwards and JenaValve from consummating the transaction. The court’s decision identified a market encompassing research and development for products not yet commercially available. The court found that competition between Edwards and JenaValve, even before commercialization, had influenced innovation because it had spurred the parties to improve their TAVR-AR devices and bring them to market sooner. As seen in the Sevita–BrightSpring transaction, the Edwards–JenaValve ruling also emphasizes that non-price harms are significant to antitrust analysis, especially in the healthcare sector.

  • Parties Abandon Laser Eye Surgery System Transaction

    The second medical device deal abandoned in the first quarter following FTC action was Alcon Research, LLC’s (“Alcon”) approximately $430 million acquisition of LENSAR, Inc. (“LENSAR”). According to an FTC statement, the transaction would have combined the two most significant players in the market for laser systems used in femtosecond laser-assisted cataract surgery (“FLACS”). The FTC also stated that both companies had been “locked in a price war” that benefitted doctors and patients and spurred innovation in FLACS systems. The parties first announced the acquisition on March 24, 2025, and the parties received requests for additional information, or “Second Requests,” from the FTC on May 21, 2025, according to a LENSAR SEC filing. The parties then announced on March 16, 2026, that they had agreed to terminate the deal. While the FTC had no occasion to publicly detail its theories of harm, its public statement indicates that the FTC viewed the acquisition as an attempt to eliminate a rival to avoid competitive pressures on pricing and innovation.

• Non-Merger Enforcement Actions

  The FTC and DOJ were also active in pursuing a range of non-merger enforcement actions affecting the healthcare sector. The FTC announced a settlement in an administrative action concerning the pricing practices of pharmacy benefit managers, while DOJ filed two civil actions challenging restrictions in hospital systems’ contracts with insurers and obtained a guilty plea in a healthcare-related bid rigging prosecution.

  • FTC Reaches Settlement with Express Scripts in Drug Pricing Action

    On February 4, 2026, the FTC announced a proposed settlement with Express Scripts, Inc. (“ESI”) in an enforcement action alleging that pharmacy benefit managers (“PBMs”) artificially inflated the prices of insulin drugs. The FTC filed its administrative complaint in this action on September 20, 2024 against PBMs ESI, Caremark, and Optum and their respective group purchasing organizations (“GPOs”). The complaint alleged violations of Section 5 of the FTC Act, which prohibits unfair methods of competition and unfair or deceptive acts or practices. Section 5 is more flexible than the Sherman Act and the Clayton Act, and arguably prohibits a wider range of conduct. The FTC alleged that the PBMs, which negotiate rebates and fee rates with drug manufacturers, created an unfair drug rebate system that compensated the PBMs based on reductions from manufacturers’ list prices. This system allegedly encouraged manufacturers to artificially inflate their list prices, and the PBMs consistently excluded alternative versions of drugs with low list prices. As a result, patients with out-of-pocket expenses, such as deductibles and coinsurance based on list prices, allegedly ended up paying more for insulin and other drugs.

    Under the proposed consent order, ESI agreed to adopt a wide range of changes to its business practices, which the FTC estimates will reduce out-of-pocket costs for insulin and other drugs by up to $7 billion over 10 years. ESI must provide a standard offering to its plan sponsors tying members’ out-of-pocket expenses to drugs’ net cost after rebates, instead of list prices. Also, ESI must stop preferring high-cost versions of drugs over identical versions with lower wholesale acquisition costs. Other terms of the consent order do not directly relate to the challenged rebate system and more closely track the Trump administration’s America First priorities. For one, ESI must reshore its GPO from Switzerland to the United States. In addition, ESI must provide covered access to the Trump administration’s prescription drug marketplace, TrumpRx, as part of its standard offering. As of the date of publication, the enforcement action remains active against Caremark and Optum.

  • DOJ Brings Action Against OhioHealth for Health Plan Restrictions

    DOJ was also active in non-merger enforcement in the first quarter of 2026. First, on February 20, 2026, DOJ, joined by the Attorney General of Ohio, announced the filing of a civil antitrust lawsuit against hospital system OhioHealth Corporation (“OhioHealth”). The plaintiffs allege in the complaint that OhioHealth leveraged its market power in the Columbus, Ohio area to impose restrictions in contracts with payors that prevent the payors from offering certain health insurance plans or plan features, in violation of the Sherman Act and Ohio’s Valentine Act. In particular, OhioHealth allegedly forced payors to include OhioHealth in their networks for all offered commercial insurance products, regardless of OhioHealth’s prices. As a result, payors allegedly could not develop “budget-conscious plans” limited to other lower-cost providers. Like the FTC’s drug pricing action against PBMs, the OhioHealth action targets healthcare prices directly paid by lower-income consumers.

  • DOJ Brings Action Against New York-Presbyterian for Health Plan Restrictions

    On March 26, 2026, DOJ announced the filing of a civil antitrust lawsuit against The New York and Presbyterian Hospital (“New York-Presbyterian”), challenging restrictions in its payor contracts. The legal theories in this enforcement action are similar to those in the OhioHealth action. In its complaint, DOJ alleges that New York-Presbyterian used its market power in New York City to impose restrictions in contracts with payors that reduced consumers’ choice of healthcare plans. Some restrictions allegedly prevented insurers from offering plans that did not include access to New York-Presbyterian or that did not feature the hospital system in the plan’s most favored tier. Moreover, New York-Presbyterian allegedly imposed restrictions on payors offering lower copays to patients for services at lower-priced competing hospitals. Again, DOJ alleged that these contractual restrictions blocked the development of “budget-conscious plans” and protected New York-Presbyterian from price competition.

  • DOJ Secures Guilty Plea in Healthcare-Related Bid Rigging Prosecution

    Healthcare intersects with DOJ’s push to tackle antitrust crimes affecting public procurement through the Procurement Collusion Strike Force (“PCSF”), a joint initiative with multiple U.S. Attorneys’ Offices, the Federal Bureau of Investigation (“FBI”), and Inspectors General of multiple federal agencies. The PCSF, first announced in 2019, leads a national effort to investigate and prosecute bid-rigging and other fraudulent conduct affecting government procurement, grant, and program funding.

    For one example of the PCSF’s efforts, on March 18, 2026, DOJ announced that a defendant had pleaded guilty to two felony counts for conspiring to rig bids and defraud the U.S. Department of War in connection with the sale of shelving and storage products to the U.S. Air Force for use in healthcare facilities. The defendant and unnamed co-conspirators allegedly submitted collusive bids for multiple healthcare-related projects totaling over $1.6 million at Moody Air Force Base in Valdosta, Georgia. A co-conspirator allegedly instructed the defendant to submit higher prices on bids and provided the defendant with pre-filled bid forms, which the defendant re-wrote in his own handwriting before submission. The defendant pleaded guilty to felony counts of conspiracy to rig bids in violation of the Sherman Act and conspiracy to defraud the United States. DOJ stated that this guilty plea is the first in an ongoing investigation, signaling that more prosecutions may be forthcoming.

III. Private Actions

Private antitrust litigation involving the healthcare sector was also highly active in the first quarter of 2026. The following cases, which involve algorithmic pricing of out-of-network claims, access to weight loss drugs, and group purchasing organizations, represent a sample of the key private antitrust cases over this timeframe.

• Court Denies Motion to Dismiss Claims Against Zelis and Payors

  On March 30, 2026, the U.S. District Court for the District of Massachusetts denied the defendants’ motion to dismiss claims that healthcare technology vendor Zelis conspired with payors Aetna, Cigna, Elevance, Humana, and UnitedHealthcare to suppress out-of-network reimbursement rates paid to providers. The plaintiffs allege that Zelis offers “repricing” services to payors to set reimbursement rates for healthcare services provided on an out-of-network basis. The plaintiffs further allege that Zelis and payors conspired to suppress reimbursement rates far below competitive levels and that providers have no meaningful opportunity to negotiate the repriced amounts that Zelis presents. The plaintiffs’ allegations are similar to those in another ongoing antitrust action against a larger out-of-network repricing vendor, MultiPlan (now known as Claritev). On June 3, 2025, a federal district court denied a motion to dismiss filed in the MultiPlan litigation, which is currently in discovery.

  In denying the motion to dismiss in the Zelis litigation, the court found that the plaintiffs had plausibly alleged antitrust standing because they could not negotiate the repriced claims and could not bill their patients for the balance of the underpayments. Also, the plaintiffs had alleged a cognizable antitrust injury based on having to accept lower prices, regardless of the prices ultimately paid by patients. Further, the court found that the plaintiffs had alleged a horizontal conspiracy between all defendants because Zelis, like the other payors, allegedly purchased out-of-network healthcare services from providers. The court also found that the plaintiffs had adequately alleged an alternative theory of a hub-and-spoke conspiracy, with Zelis acting as the central purchaser, and the other payors entering into vertical agreements with Zelis and horizontal agreements among themselves to suppress reimbursement rates.

• Pharmacy Alleges Suppressed Competition for GLP-1 Drugs

  The popularity of groundbreaking weight loss drugs known as GLP-1s, such as Ozempic and Zepbound, has given rise to antitrust litigation. On January 14, 2026, a compounding pharmacy filed a complaint in the U.S. District Court for the Western District of Texas alleging that pharmaceutical companies Eli Lilly & Co. (“Eli Lilly”) and Novo Nordisk used their dominant positions in the GLP-1 market to suppress competition for the drugs. Compounding pharmacies produce and sell versions of drugs personalized for individual patients. The plaintiff alleges that Eli Lilly and Novo Nordisk launched their own online pharmacies and entered into exclusive agreements with telehealth providers preventing them from transacting with compounding pharmacies. The complaint asserts claims for monopolization and restraint of trade under Sections 1 and 2 of the Sherman Act. Since the complaint, the competitive landscape has shifted, as the U.S. Food & Drug Administration (“FDA”) has proposed excluding GLP-1s from a list of drug substances that may be used in compounding.

• Fifth Circuit Affirms Rejection of Antitrust Claims Against Medical Supplier

  On January 13, 2026, the U.S. Court of Appeals for the Fifth Circuit affirmed the dismissal of antitrust claims on summary judgment brought by medical supplier Endure Industries (“Endure”) against group purchasing organization (“GPO”) and medical supplier Vizient Inc. (“Vizient”). Vizient negotiates prices on medical products on behalf of hospitals and also maintains its own white-label medical products. Endure alleged that Vizient had unlawfully excluded competitors by forcing other suppliers to use its purchasing programs to transact with hospitals and penalizing buyers who attempted to purchase goods from other suppliers. The U.S. District Court for the Northern District of Texas granted summary judgment for Vizient, finding that Endure had failed to establish its proposed relevant market limited to GPOs. The Fifth Circuit affirmed the dismissal, finding that a relevant market of supplies purchased through GPOs was legally deficient because hospitals made a significant portion of their purchases outside of GPOs, making the proposed market too narrow. This ruling could strengthen GPOs’ discretion over pricing and offerings within their purchasing programs.

  Antitrust litigation active in the first quarter of 2026 was highly varied both with respect to the types of industry participants involved and the legal theories asserted. As such, companies throughout the healthcare sector should stay attuned to emerging issues in antitrust litigation and enforcement and ensure their compliance programs are up to date. Experienced counsel can help companies navigate the complex and rapidly changing legal landscape.

This information is provided by Vinson & Elkins LLP for educational and informational purposes only and is not intended, nor should it be construed, as legal advice.