Federal Trade CommissionRequest Seeks Investigation of Sentara Healthcare’s Business Practices as Company Asks for FTC Permission to Merge with Cone Health of North Carolina

The Federal Trade Commission has acknowledged it has received Checks & Balances Project’s request for an investigation into anti-competitive practices by Sentara Healthcare.

Attorney Alan Friedman of the FTC’s Bureau of Competition said in an email late Monday that the request has been forwarded to the appropriate people inside the FTC.

The request highlights examples of anti-competitive behavior by Sentara, particularly its use of Virginia’s Certificate of Public Need (COPN) process to block competitors from developing services in which Sentara dominates the southeastern Virginia market.

Sentara Uses COPN Process Weaken Remaining Competitors

The FTC needs to investigate the proposed merger, C&BP wrote, because Sentara has succeeded in using the COPN process to weaken its remaining competitors in the Hampton Roads area – Bon Secours and Chesapeake Regional Medical Center (CRMC).

In one case highlighted by C&BP’s reportingSentara’s objections damaged Bon Secours’ attempts to restructure its hospitals in the area, leading to its decision in January to close the 165-year-old DePaul Medical Center. DePaul was located in an underserved community and had the highest rate of charity care in the state.

Sentara Sued by Rival Chesapeake for “Tortious Interference”

Just last week, CRMC sued Sentara for tortious interference related to Sentara’s poaching of cardiologists from CRMC while Sentara also fought its COPN application to start an open-heart surgery unit.

For more than 30 years and through the administrations of six presidents of opposing political parties, the Federal Trade Commission has criticized certificate of need laws (CON, another name for Certificate of Public Need, or COPN) as anti-competitive and ineffective in slowing the rise in health care costs.

Sentara registered with the IRS as a tax-exempt nonprofit charity but has net assets of $6 billion. We’ve been probing how the healthcare giant that’s seeking to expand into North Carolina uses lobbying and influence to crush competitors, the lengths it goes to do that and the impact on average citizens.


Ray Locker is enterprise and investigative editor of Checks and Balances Project, an investigative watchdog blog holding government officials, lobbyists, and corporate management accountable to the public. Funding for C&BP is provided by Renew American Prosperity and individual donors.


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“A monopoly position is not enough – Sentara also seeks to eliminate competitors”

Virginia’s Certificate of Public Need Process Needs a Road Map

5 Things To Know About Certificate of Public Need Laws

Attorney Jamie B. Martin Was “Legal Advisor” to COPN Reform Group — But Didn’t Publicly Disclose Sentara Connection

Judge Ruled for Sentara, Once Represented the Company with Sentara’s Lawyer