FTC Announces Agreement in Principle with U.S. Anesthesia Partners to Resolve Antitrust Case Over Texas Roll-Up Scheme

The U.S. Federal Trade Commission (FTC) recently announced that it has reached an agreement in principle with U.S. Anesthesia Partners Inc. (USAP). This step is intended to resolve the pending litigation initiated in 2023, which alleged that the company engaged in systematic anticompetitive conduct in the state of Texas.

The case was originally filed by the FTC in 2023. In its complaint, the agency charged that USAP violated federal antitrust laws through a decade-long “roll-up scheme,” systematically acquiring nearly all large anesthesia practices in Texas.

In its official statement, the FTC explicitly claimed that USAP’s strategy was designed to bring various service providers under common control, thereby establishing a position of dominant market power in the state. Leveraging this market advantage, USAP was able to significantly inflate anesthesia service prices. According to agency estimates, the company’s multifaceted anticompetitive strategies resulted in tens of millions of dollars in excess annual anesthesia costs for Texas residents, substantially harming patient interests.

Although the agreement in principle represents a significant step toward resolving the dispute, the FTC stated that the specific core terms of the agreement remain confidential. This confidentiality is intended to provide USAP with sufficient time to complete subsequent business negotiations and implement related remedial measures.

The FTC also emphasized that the agreement does not yet have final legal effect. Should USAP fail to strictly comply with the settlement terms during subsequent implementation, the Commission will return to federal district court to continue pursuing litigation regarding the allegedly unlawful acquisition practices.

The settlement has been approved by the FTC in a 2-0 vote, authorizing staff to proceed with next steps. Meanwhile, the FTC’s healthcare division has been authorized to seek a stay of litigation in district court, allowing USAP to begin implementing specific relief measures for Texas consumers.