The Federal Trade Commission is examining Epic Systems Corp., the nation’s largest vendor of electronic health records, for potential violations of antitrust law as part of a broad inquiry into the company’s business practices, according to three people who were recently contacted by investigators.

The probe is in its early stages and may never lead to charges against Epic, whose dominant market position and control of Americans’ health data has rapidly accelerated in recent years. But the people contacted by investigators — who work in or advise health care businesses that interface with Epic — said they were asked about a wide range of issues relating to company policies and practices that have generated continual complaints and lawsuits from former employees and rival companies.

One of the people said the government appears to be pursuing two separate lines of inquiry. One is focused on Epic’s agreements that bar its employees from working for a wide swath of health care businesses that directly, or indirectly, compete with the company. Another set of questions focused on Epic’s use of its dominant market position, and leverage over its hospital customers, to block rival technology companies from getting access to patient data and information needed to support their businesses.

Epic’s main product is electronic health record software that chronicles patients’ medical histories and forms the digital backbone of medical services delivered to millions of Americans. Its clients are the largest and most influential hospitals in the country. In recent years, the Wisconsin-based company has also branched into related businesses serving health insurers and other large health care entities.

The FTC is not alone in pursuing the inquiry. Attorneys general in states across the country have also joined calls with interview subjects or reached out to their private lawyers to ask for information, according to all three people who spoke with STAT.

Federal investigators do not appear close to filing charges and may examine Epic for several years without doing so. The people contacted said the intensity of interest, and the number of entities involved in the inquiry, has been ramping up in recent months.

In an emailed statement, Epic did not affirm or deny whether it had been contacted by the FTC or was aware of the agency’s interest. “We’re leaders in interoperability to support patient care, and we do not engage in anticompetitive behavior,” a company spokesperson said, listing its data-sharing accomplishments like being the first EHR to connect to the national record-sharing network, its newly announced standards for exchanging diagnostic images, and its 1,000-plus developer connections.

The FTC told STAT it had no comment.

Epic started in a basement in Madison, Wisconsin, in 1979. The company’s founder and chief executive, Judith Faulkner, scraped together $70,000 from friends, family, and acquaintances to buy a hulking-by-today’s-standards “minicomputer” and founded the health IT empire that today handles the electronic medical records for 57% of inpatient hospital beds in America. Approximately 82% of Americans have at least one record stored by Epic, whose annual revenue was $5.7 billion in 2024, up from $3.3 billion in 2020.

The increasing interest of federal investigators in the company follows the filing of several private lawsuits against Epic by rival business and former employees.

A 2025 lawsuit from CureIS Healthcare, a company that makes software for managed care organizations, alleges that Epic began blocking its access to data held within customers’ own instances of Epic, part of a playbook it says the company uses to undercut third-party software vendors.

CureIS’s programs need data from Epic’s EHR in order to perform services for its health system clients. At a certain point, Epic decided that CureIS was a “direct competitor” with its Tapestry product, says the company in the complaint, and began denying CureIS access to customers’ own information — for example, that of Advocate Health. Epic subsequently pressured the companies’ shared customers to not work with CureIS, saying that it “wasn’t comfortable” with CureIS accessing its systems for data security reasons, which CureIS asserts is false.

The company also instituted an “Epic-first policy” under which it requires its customers “to abandon any preexisting third-party tools and forgo exploring non-Epic solutions at any point in the future if Epic believes it has a tool or service that overlaps with the third party’s option,” wrote CureIS in its complaint — a policy that applies even if Epic doesn’t currently have an active product that does what the third parties do. To underscore the breadth of Epic’s ambitions, CureIS points to an Epic brochure entitled “Products You Can Replace with Epic,” which outlines 323 products under 21 categories, 16 of which were purportedly labeled “under development” and thus not yet available.

Epic declined to comment on the private lawsuits facing it. In its motion to dismiss the CureIS suit, the company said that the case is “based on the misguided notions that Epic is obligated as a matter of law to keep CureIS in business and that Epic is somehow prohibited from communicating with its own customers about what features it already offers, or what future innovations it will soon offer.”

The company blames Epic’s interference for the loss of at least seven customers, including California-based Sutter Health. It also says it lost a nine-figure acquisition deal with a “major private equity firm” when the firm found out that the reason CureIS lost a customer was because it was in “Epic’s development crosshairs.”

A related argument underlies the Particle Health antitrust suit against Epic, in which Particle says that Epic used a pretext — in which Particle customers inappropriately accessed medical records held by Epic — to cut off its customers’ access to patient records, coerced customers to move their business from Particle to other companies, and publicly destabilized Particle’s business to the point where the company lost at least 10 customers.

Epic has called the Particle suit “nothing more than a baseless retributive attack” because Epic’s actions revealed inappropriate behavior from Particle customers. Some claims in that lawsuit have already been dismissed.

Epic is also facing labor lawsuits regarding its unusually restrictive non-competes and stock purchase agreements. Earlier this year, clinical trial management software company Veeva Systems sued Epic in Wisconsin court over its restrictive non-compete and stock purchase agreements. Veeva’s Madison office had hired Epic employees in the past and was trying to hire other Epic employees, it said in the complaint, but recently became stymied by candidates being too scared to lose their Epic stock by taking a job at Veeva. The company contended that it does not compete with Epic and that its 2025 addition to Epic’s non-compete list was retaliatory.

The case was dismissed because Veeva did not have legal standing — the company was not party to the contract between Epic and its employees. The company is appealing that judgement.

However, another labor case filed by a former Epic employee, Andrea Hull, is still pending in California. Hull, who now works for the medical device company Abbott, contends that Epic has sought to block her from performing her duties for Abbott by denying her access to Epic’s UserWeb under Epic’s non-compete, which should be void in the state of California. Epic declined to comment on the lawsuit.

As it faces down those lawsuits, several of Epic’s top technology leaders have left the company in recent months, citing a variety of reasons. Sumit Rana, who was long rumored to be Faulkner’s heir apparent, in early July said he was leaving the company for personal reasons. Seth Hain, a longtime AI leader at Epic, followed soon after, remaining publicly silent about the reason for his departure. Aug. 14 was Rana’s and Hain’s last day at Epic.

Several other longtime executives have also recently left the company. Those departures may be entirely unrelated to the investigations circling the company. But current and former employees are being named in the private lawsuits and may also be getting inquiries from government investigators.

The people interviewed by the FTC said the probe appears to be expansive and has not yet narrowed in on specific allegations. The agency in recent years has launched an array of investigations into anticompetitive behaviors by some of the nation’s largest technology companies, including Amazon and Meta.

Epic, a privately held company, is small in comparison to those businesses. But in health care, its presence has become unavoidable, especially amid a rapid rise in the number of companies using artificial intelligence to deliver services to patients and hospitals. Many of those companies, by necessity, must rely heavily on getting access to patient data held within Epic’s software ecosystem to run their businesses.

But Epic has long faced criticism that it has made it difficult for outside companies to gain access to its data and intellectual property. One recent study titled “A problem of Epic proportions” called for urgent government action to break up Epic’s monopoly, asserting that doing so would improve patient care and allow more innovative technologies to reach consumers.

“The U.S. now faces a choice: allow one vendor to dictate the terms of healthcare’s digital future, or reclaim health information as a public resource, governed in the interests of patients, clinicians, and society,” the study concluded. “Confronting Epic’s monopoly is not merely a matter of market fairness, it is essential for the future of healthcare innovation, governance, and patient care.”