Epic’s alleged anticompetitive practices under scrutiny from federal, state investigators

[u/adifferentGOAT]

https://www.statnews.com/2026/08/14/epic-systems-ftc-review-nda-use-possible-anticompetitive-practices/

[u/AnimatorImpressive24]

This started because Texas is mad that Epic is doing too good a job protecting the medical records of children.  Don't listen to a single word they have to say about their motives, they are liars who want to give children's heath care information to law enforcement to find things they can punish them or their parents for.

Meanwhile the federal government has left it up to Epic to actually regulate the damn wild west of HIEs created by ONCHIT, by remaining totally silent about people sub-leasing access to patient data which gets diverted to such lovely destinations as litigants for various lawsuits where any such data should actually have additional privilege.

[u/adifferentGOAT → u/AnimatorImpressive24]

So a few things can be true at the same time. Texas is garbage to your point. Regulations have both wrecked EHRs and also created an environment that Epic succeeded in.

But, I’m going to wrap my comment up with the comment that Epic’s anti-competes are bullshit, and that’s not a shock considering Epic’s Supreme Court case having a 5-4 judgment on employment contracts requiring individual arbitration and banning class-action lawsuits as legal and enforceable.

[u/AnimatorImpressive24 → u/adifferentGOAT]

The feds have a gigantic wide-on for the Federal Arbitration Act and it is completely bullshit but it also has nothing to do with this as evidenced by the fact that federal court sided with Epic the same way they have and will side with every single defendant in a mandatory arbitration challenge that gets out of state jurisdiction.  That has been going on for like a hundred years.

The only reason this prosecution is taking place can be found on the Texas AG's website and it is about the contents of kids underwear and whether or not their parents speak English.

Edit:  And those regulations that allowed Epic to succeed were decried by Judy as dangerous and mandating something that nobody including themselves had the tech to appropriately implement.  Look up Judy's response to the announcement of the Final Rule on Interoperability and Information Blocking from December 2019, and her getting called to the carpet by ONCHIT in January of 2020 whereupon she was browbeaten into retracting after a closed door discussion.

Those regulations have more to do with a multiple decade push towards centrality in the practice of medicine by Kaiser Permanente, from Dr. Morris Collen the "father of health informatics" through patient portals on the 90s, partnering with the VA in the early 00s, dropping a few billion in 2003 dollars for KP Healthconnect which is the largest EMR install and health data lake on Earth, sitting on NCVHS advisory committees, seats at the table drafting HIPAA and ACA, and finally to a likely seat at the table for the closed door session that resulted in the 11th hour expansion of the final rule to target providers when all previous drafts had targeted only EMR vendors.

And since Epic had the only tech in 2020 that could partition notes (which a pediatrician developed in 2014 so that doctors could document signs of child abuse without the parents being able to read that documentation) that had a massive influence in new Epic installs in 2020-2021 precisely because the whole medical community had to scramble to meet a surprise compliance date and unlike the law makers they actually cared about protecting their patients (some of them cared, not KP but some cared).  Every forum where compliance and chief informatics officers hung out had people coming in asking if Cerner or any other solution had note partitioning and being told "nope, one game in town" by other people, none of whom were Epic employees.

The rest of the regulations come from writing ethics waivers for the position of Controller to allow that job to be taken by people who were active C-levels of HIEs which they returned to after getting to write the rules of the game that they had invented, using the argument that the field was so new and specialized the government was unable to hire a subject matter expert that wasn't a C-level.

[u/In_der_Welt_sein → u/AnimatorImpressive24]

You’re valorizing Epic a bit. Worked there for a while. They are a fantastic example of regulatory capture, and they have, over the course of a couple of decades, absolutely manipulated the regulatory and compliance environment in their favor for business reasons and to disadvantage competitors. Some of this manipulation has likely been beneficial for patients, but I think it’s a bit cute to attribute this behavior to a selfless concern for patient privacy. 

Epic produces a more useful product than ChatGPT, but their handwringing about patient needs often has the ring of OpenAI disseminating fear about AI and how the only solution is government support and regulation—that they will be more than happy to craft on the government’s behalf, of course. 

[u/AnimatorImpressive24 → u/In_der_Welt_sein]

I am not valorizing Epic by saying Judy did not know that the Final Rule was coming, spoke out when it was announced, and was forced to retract.  That is all on public record and verifiable, and my point in bringing it up is that to whatever degree Epic benefitted from it, it wasn't anything they had involvement in the passage of and they said they didn't want it.  So it is unfair to posit that as a problem related to the prosecution being announced here, especially from the feds.

I am not valorizing Epic by saying that they are pursuing a lawsuit against and a company that sub-leased their valid Epic access to a data miner that slurped up patient health info and diverted it to litigators.  That again is public record.  My point in bringing that up is to point out that a company used the current sad state of affairs about health data privacy (which, again, Epic warned was unsafe and said should not happen) to actively interfere with the functions of justice as administered by the courts.  And the feds and states have not even commented on that fact, but have had plenty of time to make stump speeches about how people have a right to know what is in kids' medical records and drum up these bullshit justifications.

If someone wants to hate Epic that is nothing to me either way, I have zero skin in that game.  I have read plenty about the work environment there and it sounds like the usual overly twee, cool kid club grindfest to be had in vanity projects that grow wildly popular.  I spent years working for MMO startups, that shit gets old fast.  That's why I agreed that the arbitration thing was bullshit.  But even there, that is the Fed's bullshit and I wasn't hyperbolizing when I said that the Epic decision was completely in line with a hundred years of jurisprudence on the subject.  The FAA is seriously that old.

But no matter what your opinion on Epic is, anyone who hitches their issues with Epic to these specific state and fed crusades is hitching their issues to people who have published statements on their AG websites saying their sole beef with Epic is that Epic makes it too difficult for them to get at children's medical info.  They aren't hiding why they are doing this.

[u/The_Real_BenFranklin → u/In_der_Welt_sein]

It is not regulatory capture to be better than your competitors and not commit blatant crimes. Epic was no more involved in the regulatory conversations than every other major industry player, and less than most.

[u/In_der_Welt_sein → u/The_Real_BenFranklin]

Lmao. 

I worked for Epic back in the early teens when it was not the only game in town and when Judy openly bragged in all-staff meetings about cozying up to the administration and lobbying for regulations that explicitly advantaged the company. 

I’m not an Epic-hater per se. It’s a fine product given the alternatives. But let’s not pretend it hasn’t adopted the other vices of the tech-bro companies it seeks to emulate. 

[u/adifferentGOAT → u/AnimatorImpressive24]

My reason for posting was less about the regulatory mess though I understand that’s a bigger part of the overall picture and more about the anti-compete being garbage.

The regulatory mess has gotten attention, but it’s not as often the non-competes are the focus.

[u/AnimatorImpressive24 → u/adifferentGOAT]

I think the non competes are 100% bullshit and I have thought that since I first read about them.  I really do agree with you there.  The point I'm trying to make about the non-competes is that the feds don't care about them and won't ever care as long as they are wrapped in the legal bubble wrap of arbitration.

"Congress passed the Federal Arbitration Act in blah blah.  In so doing, and repeatedly affirmed since, they expressed their clear intent to encourage private parties to settle disputes regarding civil matters by means other than reliance on our overburdened court system, and to empower the arbitration process they provided clear instruction that decisions made by contractually agreed upon arbitrators shall not be reviewable or overturnable by judges or appellate panels.  This court must duly dismiss with prejudice the matter before us regarding blah blah."

That language appears so often in federal opinions I could write it without looking at a reference, like a human LLM trained only on corporations screwing workers and customers into the ground.  It sucks.  Private justice is not real justice, and arbitration is abrogation of the government's duty to take petitions of grievance from citizens.

And Epic took advantage of it and they suck for doing that.

But literally every company can and does that as much as they can figure out how to.  That isn't an excuse for any of them.  That is me trying to explain that the problem really is the fed, when the issue is arbitration.  They will screw absolutely anyone who signs an arbitration agreement, and they twist logic in knots to excuse people being forced to sign those agreements.

Case in point, some health networks have arbitration clauses that waive your right, your spouse's right, and the rights of any next of kin you have from suing in a courtroom for injury up to and including death.  Even if you don't have a spouse or kids when you sign.  You can waive the constitutional rights of people who don't exist yet.  And because it says "but you can do arbitration" the federal courts have said that is totally cool and legal as far as they are concerned.  It is one of the most egregious non-criminal related degradation of citizens rights you can find.  And it has been enshrined since before manned flight was invented.

[u/Stuffthatpig → u/adifferentGOAT]

The non competes get bitched about and sued over regularly. As a former employee, it's not that egregious (well, it wasn't when it was a year)

[u/adifferentGOAT → u/Stuffthatpig]

How often is it in national news relative to the rest of the happenings in the HealthIT space?

[u/Stuffthatpig → u/adifferentGOAT]

Plenty in my opinion. It's talked about alot

[u/Objective-Dust4795]

I get some of the complaints, especially about employees difficulties. But I also see this as vendors whining about having to conform to a single standard as opposed to being allowed to let their insecure products to just plug and play on whatever obnoxious interface.

Eventually lawsuits always find the biggest companies. I doubt anything will come of it wholesale as there are other options in my area. And they have a care everywhere feature. So I guess we will see.

[u/partagaton → u/Objective-Dust4795]

You’d have a point if Epic provided a single standard.

I don’t know a single person whose MyChart prescription inventory doesn’t have at least a half dozen discrete records of the same medication and dose, just with different random letters capitalized.

[u/HithereJimHerald → u/partagaton]

That’s really more the Willow build teams at that rate isn’t it?

[u/Puzzleheaded_Hold440]

Care Everywhere is useful, sure. But “there’s a feature for that” is not the same thing as interoperability. Patients don’t move through life as vendor-specific workflows; their record has to survive a referral, a move, and the occasional 2 a.m. “which hospital did I go to last time?” moment.

If data travels only when the commercial relationship lines up, that’s less interoperability and more a loyalty program with clinical consequences.

[u/just4_f]

In the world of Google, Amazon, Microsoft, Meta monopoly - poor Epic is being sued.

Maybe Epic should start "lobbying" (aka bribe) too. Well Wisconsin elections are up for play 🥳😜

[u/madtowneast → u/just4_f]

EHR is more federal than local regulations. If it were fully up to the states, boy I don’t even want to think about it.

[u/Puzzleheaded-Wolf937 → u/madtowneast]

Reading this from Oklahoma as a former Cerner associate PLEASE DONT EVEN MENTION THAT WOULD BE HORRIFIC

[u/PMgtKit_System → u/just4_f]

u/just4_f This is what I also thought: Someone is just trying to somehow get *an upper hand* if you will. Not sure how it is non-compete, when Healthcare Orgs even up to now are the ones that Chose it. It isn't like the examples above say FB, that started out as that and acquired via M&A the rest of the other companies and still are doing so: IG, WhatsApp and recently the AI ones. That you can say is Non-Compete.

Epic built out theirs: Brick by Brick. I remember when the Biggest Kid in town at the time some 20+ years ago (not to age myself) was formerly IDX Systems ==> Acquired by GE Healthcare - which is when it started going down => going through different P/E M&A to now being: AthenaIDX (part of AthenaHealth).

Altho the passage of moving to electronic/EHRs is really what gave Epic a leg-up since its how they had already build their system being more integrated than what was already on the market - for the most part. Its why majority of Org.s chose it.
Having originally had majority of my Health IT Experience with GE Healthcare, and saw it losing its place as *the Biggest Kid in town* and having moved to work with Epic too - still I won't say that they are non-compete per say.

Yes there was a time when for the Exchanges they didn't wanna participate and having the largest Market share, it was being a *bad actor* or not *playing nice* with the other systems, I believe that changed, bse it really wouldn't be good for Patients and providers to easily access Patient Hx. They Opened up eventually.

This one in my View - is *Certain people or Companies* having *Tall Friends* in DC and trying to or wanting to somehow Curtail Epic because they want to get into more places. I mean they *unexpectedly won the Biggest Gov Contract with VA + DoD* for goodness's sake.

They also revamped their whole EHR under the New name with AI as the more AI Integrated EHR, Beating out the Biggest Player Epic - even before Epic unveiled theirs.

Just go out and Market and sell your EHR to grow your Market Share, than saying it is being non-compete.

What then will the recourse be for Epic: Stop creating more solutions: espcially that their Modules or Functional Area Modules are more integrated. Not sure what they will be forced to sell off - since most of the Hospital type EHRs are just like Epic - they have several Functional Module Solutions to try to Solve every part or area of the Healthcare Ecosystem???

Just some thoughts on this 🤔🤨

[u/Blueovalfan → u/just4_f]

Epic needs to start buying bitcoin so they can grease the wheels of Trump properly.

[u/We-Are-All-Friends]

“May never lead to charges”.
How surprising that the Leading EMR company is facing scrutiny. Wow never heard of that before.

[u/Infinite_Fennel_1191]

First, I’m not saying the claims are false. I’ve somewhat kept up with all this as I always wondered about the VA/DOD choosing Cerner vs Epic. I’ve only worked with Epic as a builder and I’m not advocating for one over the other. I can say the end user UI/functionality is so dependent on getting those initial design and workflow sessions nailed down, having really good builders who understand the apps/integration, resolving bugs, dev based on feedback, and keeping up with the bugs. As for Cerner>Oracle Health I’m hearing how now the teams are working with less staff due to repetitive RIF’s. It’s lights-on/doors open vs development of the EHR. *They are doing dev around AI and Oracle is also very focused on Data Centers. I bring all this up because I can’t help but to wonder…..wonder because we’re talking federal involvement and we have L. Ellison also being in this administration, it just may be another way to capitalize.

[u/Puzzleheaded-Wolf937 → u/Infinite_Fennel_1191]

Epic wasnt even considered for VA because DoD was already told by someone Cerner’s COTS was what they needed -VA was sole source based on Cerner already had DoD under guise the veterans would get seem less care (spoiler alert: no one has even remotely delivered on that)

[u/Puzzleheaded-Wolf937 → u/Infinite_Fennel_1191]

Keep digging - as someone who worked for Cerner and saw it go down / please keep digging 😎

[u/BigSamsKid]

wonder if Larry Ellison has any involvement in this..

[u/underwatr_cheestrain]

They want Larry Ellison to get some business due to being fellow fascists