FTC Opens Antitrust Probe Into Epic Systems, the Company That Holds Medical Records on 280 Million Americans

The FTC is investigating Epic Systems, the company that runs the software holding medical records for more than 280 million Americans, according to two sources who spoke to Reuters and four people contacted by investigators who spoke to STAT News.

Epic is privately held, based in Verona, Wisconsin, and dominates the electronic health record market. Hospitals and clinics across the country use its platform, including the MyChart patient portal most Americans have logged into at some point. Epic also runs a research platform where health systems that opt in can pull data from 310 million patients, according to the company's own website.

That scale is exactly what regulators are looking at. Reuters reported the FTC has sent investigative demands to other companies in the health technology industry, asking how Epic grants or withholds access to patient data. STAT News, citing four people recently contacted by investigators, reported the probe covers two separate tracks.

One track examines Epic's employment agreements that reportedly bar former employees from working for a wide range of companies that compete with Epic directly or indirectly. The other examines whether Epic uses its market dominance and leverage over hospital customers to block rival tech firms from getting the data access they need to compete.

An Epic spokesperson gave the same statement to Reuters that the company has used before: "We're leaders in interoperability to support patient care, and we do not engage in anticompetitive behavior." The company did not confirm or deny to STAT News whether it had actually been contacted by the FTC.

The FTC declined to comment to Reuters. No charges have been filed against Epic, and STAT News reported the probe is in its early stages and may never result in any. Federal investigators reportedly could examine the company for years without acting.

This isn't Epic's first fight over these exact questions. Texas Attorney General Ken Paxton sued Epic in December, alleging the company shuts out potential rivals by holding data hostage through restrictions and fees. Epic has denied that, arguing its products are interoperable with outside systems and that hospitals and clinics, not Epic, control who gets access to patient records.

Separately, Particle Health, a company that competes with Epic for insurers' business reviewing and storing medical records at scale, has sued Epic, accusing it of erecting barriers to keep Particle's would-be clients away. Epic has called that lawsuit baseless and countered that Particle obtained confidential patient records under false pretenses. Particle denies that.

State attorneys general across the country have also joined interview calls or reached out to interview subjects' private lawyers, meaning this isn't just a federal matter. A federal probe running alongside a state AG's active lawsuit and coordinated interest from other state attorneys general represents a more substantial effort than a single agency investigating alone.

Epic argues, and has argued in court filings, that hospitals and health systems, not Epic, are the ones who decide who gets access to their patients' records. If a hospital chooses not to share data with a rival platform, that's the hospital's call, not evidence of an antitrust violation by the vendor whose software the hospital licenses. Epic also points to its own interoperability initiatives as evidence it's not hoarding data for competitive advantage.

The counter-argument, made by Paxton and by Particle Health in separate litigation, is that market dominance plus contractual restrictions and fee structures can functionally lock out competitors even without an outright denial of access. Whether that rises to an antitrust violation under U.S. law is exactly the question the FTC now appears to be examining, and it's a genuinely unresolved one. No court has ruled on the merits of Paxton's suit, and Particle's case against Epic remains contested litigation, not an established finding of wrongdoing.

What happens next depends on how far the FTC pushes its investigative demands and whether the agency ultimately decides there's enough to bring a formal antitrust complaint. Given the early stage STAT News describes, that decision could be years away. In the meantime, Epic continues to operate as the backbone of medical recordkeeping for the large majority of major U.S. hospital systems, a position no competitor currently threatens to displace regardless of how the antitrust questions shake out.