FTC Finalizes Conditions on Ascension’s $3.9 Billion AmSurg Deal
The Federal Trade Commission has finalized a consent order governing Ascension Health Alliance’s approximately $3.9 billion acquisition of AmSurg LLC, requiring seven ambulatory surgery centers to be divested in five U.S. metro areas.
The FTC announced the approval on August 25, 2026, after issuing the final decision and order on August 24. Ascension announced that it completed the acquisition on June 4, so the agency’s action imposes a post-closing remedy rather than blocking the transaction.
Seven centers are covered by the remedy
The order covers facilities in the Nashville, Panama City, Tulsa, Waco and Wichita areas. The affected locations are:
- Waco Gastroenterology Endoscopy Center in Waco, Texas;
- Tulsa Endoscopy Center and Eye Surgery Center of Tulsa in Tulsa, Oklahoma;
- Surgery Center of Kansas in Wichita, Kansas;
- Associated Endoscopy in Hermitage, Tennessee; and
- St. Thomas Medical Group Endoscopy Center and NGS Endoscopy Center in Nashville, Tennessee.
Six centers are designated for divestiture to SC Affiliates. The Panama City facility, Northwest Florida Gastroenterology Center, is designated for WRCC Gastro LLC, which the final order calls Panama City Doctors. The order identifies the required buyers and related agreements, but it does not by itself show that every transfer has formally closed.
Ascension must provide transition assistance and maintain business information and assets during the transfer process. That assistance can include support involving personnel, billing, credentialing, information technology, supplies, regulatory authorizations and patient-transfer logistics.
For patients and physicians, the practical questions are when each transfer closes, whether ownership or operating arrangements change, and how the centers maintain appointments, records, staffing and payer relationships during the transition.
Why the FTC intervened
The FTC’s complaint alleged that the acquisition could lessen competition for certain outpatient gastroenterology, ophthalmology and orthopedic services in the five affected markets.
The agency said that reduced competition could lead to higher surgery prices and threaten care quality and innovation. Those are the FTC’s allegations and competitive findings about potential harm. They do not establish that prices, quality, access or patient outcomes have already changed.
The final order settles the allegations for purposes of the enforcement matter. It states that the respondents admitted jurisdictional facts but did not admit, for settlement purposes, that the law was violated or that the substantive allegations were true.
The remedy is limited to specified assets and services in the five areas. It does not undo the entire Ascension-AmSurg transaction or automatically cover every facility operated by either organization nationwide.
Oversight continues for 10 years
The order remains in effect for 10 years. During that period, Ascension must provide advance written notice to the FTC before acquiring certain ambulatory surgery centers that perform the covered services in the affected areas. It also cannot reacquire any of the divested facilities.
The FTC order appoints an independent monitor to observe and report on compliance. Ascension must notify the agency of the acquisition date and each divestiture date, submit the completed divestiture agreements, and file interim compliance reports every 60 days until specified obligations are complete, followed by annual reports for nine additional years.
What to watch next
The next developments are the formal closing dates for the seven divestitures, the operators’ plans for each center and any compliance findings from the FTC or its monitor. If Ascension does not complete the required transfers, the order allows the commission to appoint a divestiture trustee and pursue other available remedies.
The case illustrates how federal regulators can impose structural remedies after a major health-care transaction has closed. Instead of requiring Ascension to abandon the acquisition, the FTC approved the deal subject to asset sales, transition obligations, advance-notice requirements and continuing oversight in local outpatient-care markets.
Sources
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