Key Takeaways
- • The FTC settled its antitrust lawsuit against U.S. Anesthesia Partners (USAP), a private equity portfolio company of Welsh, Carson, Anderson & Stowe, over allegations of illegal market consolidation in Texas spanning a decade-long rollup scheme.
- • USAP systematically acquired more than a dozen anesthesia practices comprising approximately 1,000 doctors and 750 nurses to create a dominant provider capable of raising prices, allegedly costing Texas consumers tens of millions of dollars annually in excess healthcare costs.
- • Settlement terms remain confidential pending USAP's execution of required remedies to restore competitive market structure; if the company fails to comply, the FTC retains the right to resume litigation in district court.
- • The settlement represents a significant enforcement action by Biden-era FTC antitrust regulators against private equity rollup strategies in healthcare, though the Trump administration has signaled willingness to settle on adequate terms while continuing to prioritize healthcare enforcement.
- • USAP Chairman Scott Holliday stated the company agreed to settle despite believing it operated responsibly and maintains strong legal defenses, citing the substantial costs and disruption of protracted litigation.
Summary
The Federal Trade Commission has reached a settlement agreement with U.S. Anesthesia Partners (USAP) to resolve antitrust charges brought in 2023 alleging systematic illegal consolidation of anesthesia services across Texas. USAP is a portfolio company controlled by private equity firm Welsh, Carson, Anderson & Stowe. The settlement was filed in federal court on April 23, 2026, concluding a major enforcement action targeting private equity rollup strategies in healthcare markets.
The FTC's original complaint alleged that USAP engaged in a decade-long scheme to acquire nearly every large anesthesia practice in Texas, creating a single dominant provider with pricing power. The consolidation involved more than a dozen practices, approximately 1,000 physicians, and 750 nurses. According to the FTC, USAP leveraged this market dominance to demand substantially higher prices for anesthesia services, imposing tens of millions of dollars in excess annual costs on Texas consumers.
Under the settlement agreement, USAP will undertake negotiations to execute terms designed to restore competitive market structure in Texas anesthesia services. The FTC has marked settlement details as confidential to facilitate these ongoing negotiations. However, the agency stated the deal will comply with longstanding FTC settlement best practices and explicitly reserved the right to resume litigation if USAP fails to fully execute required remedies. The Commission voted 2-0 to authorize staff to proceed with the preliminary settlement, and final resolution will require both Commission approval and district court authorization.
USAP Chairman Scott Holliday stated in response that while the company believes it has operated responsibly in Texas and maintains strong legal defenses against the FTC's claims, settlement was preferable to continued litigation given "uncertainties in any legal proceeding" and the substantial time, energy, and financial commitments required by extended litigation. The company emphasized commitment to maintaining focus on delivering high-quality anesthesia services. The FTC previously settled with Welsh, Carson, Anderson & Stowe in early 2025 before reaching this agreement with the portfolio company itself.
The FTC's original complaint alleged that USAP engaged in a decade-long scheme to acquire nearly every large anesthesia practice in Texas, creating a single dominant provider with pricing power. The consolidation involved more than a dozen practices, approximately 1,000 physicians, and 750 nurses. According to the FTC, USAP leveraged this market dominance to demand substantially higher prices for anesthesia services, imposing tens of millions of dollars in excess annual costs on Texas consumers.
Under the settlement agreement, USAP will undertake negotiations to execute terms designed to restore competitive market structure in Texas anesthesia services. The FTC has marked settlement details as confidential to facilitate these ongoing negotiations. However, the agency stated the deal will comply with longstanding FTC settlement best practices and explicitly reserved the right to resume litigation if USAP fails to fully execute required remedies. The Commission voted 2-0 to authorize staff to proceed with the preliminary settlement, and final resolution will require both Commission approval and district court authorization.
USAP Chairman Scott Holliday stated in response that while the company believes it has operated responsibly in Texas and maintains strong legal defenses against the FTC's claims, settlement was preferable to continued litigation given "uncertainties in any legal proceeding" and the substantial time, energy, and financial commitments required by extended litigation. The company emphasized commitment to maintaining focus on delivering high-quality anesthesia services. The FTC previously settled with Welsh, Carson, Anderson & Stowe in early 2025 before reaching this agreement with the portfolio company itself.
Go deeper than the headline
Research every firm in this story, track the ones that matter and get the daily briefing — free for 7 days.