Antitrust Law Daily Wrap Up, ACQUISITIONS & MERGERS NEWS: FTC requires divestments for Ascension Health-AmSurg deal to proceed, (Jun 3, 2026)

By Donielle Tigay Stutland, J.D.

The Consent Agreement requires the divestiture of AmSurg’s majority interests in seven ambulatory surgery centers in five relevant geographic markets.

The FTC announced that it will require Ascension Health Alliance to divest seven ambulatory surgery centers (ASCs) in order to complete its proposed $3.9 billion acquisition of AmSurg LLC. The FTC determined that the merger would substantially reduce competition in outpatient surgical services (particularly gastroenterology, ophthalmology, and orthopedics) in five metropolitan areas. The FTC reported that the merger of the two entities could lead to “higher surgery costs, reduced quality of care, and less innovation for patients” (In the Matter of Ascension Health Alliance, Docket No. C-4832, June 1, 2026)).

Background. Ascension is a national nonprofit Catholic health system that operates hospitals, physician groups, senior living facilities, and ambulatory surgery centers. AmSurg is headquartered in Nashville, Tennessee, and operates ambulatory surgery centers across 34 states and the District of Columbia, typically through joint ventures with local physician groups. Ascension’s acquisition of AmSurg, a subsidiary of Ambulatory Topco LLC, would combine two providers of outpatient surgical services, which range from cataract surgeries to colonoscopies. The proposed transaction would transfer all non-corporate interests of AmSurg to Ascension for approximately $3.9 billion.

The complaint alleged that the proposed transaction would substantially lessen competition in each of the five relevant geographic markets for the relevant lines of commerce which are the sale and provision of (i) outpatient surgeries or procedures performed by, and under the direction of, gastroenterologists, (ii) outpatient surgeries or procedures performed by, and under the direction of, ophthalmologists, and (iii) outpatient surgeries or procedures performed by, and under the direction of, orthopedists.

Divestiture. The proposed order requires that within ten days of the acquisition, Ascension Health Alliance will divest all of its interests in the six AMSURG ASCs to SC Affiliates, an experienced national operator of ambulatory surgery centers. Additionally, Ascension Health Alliance will divest all of their interests in the Panama City, FL AMSURG ASC location, to Florida Gastroenterology Center.

The proposed consent order also contains additional requirements. Pursuant to the order, Ascension, Ambulatory Topco and AmSurg must provide transition assistance for up to one year, protect confidential information, maintain the viability of the divested assets until transfer and refrain from interfering with the employment relationships at the facilities. A monitor will be appointed to oversee compliance with all divestiture and transition obligations. For a period of 10 years, Ascension also will be required to give the FTC prior notice for any acquisition of ambulatory surgical centers in the metropolitan areas around the divested surgical centers.

The proposed consent order is also subject to a 30-day public comment period.

“Access to quality surgical care at an affordable price is critically important for millions of Americans across the country,” said Daniel Guarnera, Director of the FTC’s Bureau of Competition. “The FTC’s action ordering divestitures of surgical care centers will help preserve a competitive market that will allow patients to get the care they need at a fair price.”

Companies: AmSurg LLC; Ascension Health Alliance; Ambulatory Topco LLC

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