HCA, Tenet, UHS receive FTC letter over noncompete agreements

Modern Healthcare – Wednesday, December 10, 2025
By Alex Kacik

The Federal Trade Commission sent a letter this fall to some of the largest for-profit health systems and staffing firms, including HCA Healthcare, Tenet Healthcare Corp. and Universal Health Services, warning them to ensure any employment contracts aren’t restricting competition and access to care.

In September, the FTC said it sent warning letters to several large healthcare employers and staffing firms but did not specify the number or the recipients. The agency recently disclosed the 19 companies to Modern Healthcare in response to a Freedom of Information Act request.

The letter did not explicitly accuse the organizations of using anticompetitive noncompete agreements, which can limit employees from working for competitors within a broad geography or time frame. But if the companies are using excessive employment restrictions that could limit patients’ choice of providers, they should stop, the FTC said in the document.

The FTC failed last year in its efforts to implement a nationwide ban on most types of noncompete agreements. The letter signals federal regulators still aim to crack down on the use of illegal noncompete agreements in healthcare, especially involving clinicians.

Putting the biggest national systems and staffing firms on notice could cause physicians and nurses to ask for employment contract revisions, potentially improving their wages and working conditions while boosting access to care and care continuity.

“This could lead to a wave of clinician employment contract reviews,” said a lawyer who spoke on background because they work with some of the companies that received letters. “We may see health systems investing more in clinicians and ensuring doctors are happy and staying put.”

The FTC has jurisdiction over for-profit entities, but the agency does not have clear oversight over nonprofit organizations, potentially explaining why the FTC reached out to only for-profit organizations.

Singling out for-profit companies may give nonprofit health systems an unfair advantage in the labor market, said Jeff Goldsmith, founder and president of consultancy Healthcare Futures.

“I don’t think it’s equitable to just focus on for-profit enterprises. It really tilts labor market leverage away from for-profits toward enterprises like nonprofits, which the FTC has questionable leverage over,” he said.

In addition to Nashville, Tennessee-based HCA, Dallas-based Tenet and King of Prussia, Pennsylvania-based UHS, the FTC sent letters to AMN Healthcare; Amergis Healthcare Staffing; Brentwood, Tennessee-based Ardent Health; CHG Healthcare; Birmingham, Alabama-based Encompass Health; Enhabit Home Health & Hospice; Envision Healthcare; Ingenovis Health; Jackson Healthcare; Brentwood, Tennessee-based Lifepoint Health; Medical Solutions; Ontario, California-based Prime Healthcare; Louisville, Kentucky-based ScionHealth; Select Medical; Soliant Health; TeamHealth; and Triage Staffing.

Generally, the companies said in statements that the letters do not indicate any wrongdoing and were sent to multiple companies. Here are excerpts of statements from some companies, including denials of the use of noncompetes.

Companies not listed declined to comment or did not return requests for comment.

• Ardent: “[The letter] was not directed at Ardent specifically, nor does it indicate any specific concerns. We understand the FTC is encouraging organizations across the industry to review their employment practices to ensure compliance with applicable laws and we are committed to doing so.”
• Encompass: “Encompass Health does not use noncompete agreements in our operations.”
• Envision: “Our teams use various types of agreements and, when appropriate, noncompetes that comply with local and federal guidelines.”
• Select: “The letter specifically stated that it did not intend to suggest any wrongdoing, but rather it was a statement to ensure companies are continuing to maintain compliance with federal law.”
• TeamHealth: “TeamHealth does not use restrictive noncompete agreements with its hospital-based clinicians, instead favoring a clinician’s right to choose where they want to work. Like many healthcare organizations, TeamHealth does use noncompete agreements with administrative medical directors and other senior administrative leaders whose specialized training and unique client relationships give them access to a higher level of confidential information. As requested in the FTC letter, TeamHealth conducted a review of its clinician restrictive covenants and is confident its noncompetition agreements comply with the law.”

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