Washington Sues DaVita, Fresenius Over Noncompetes
The state alleges the dialysis giants used noncompete agreements with kidney specialists to suppress competition.
Updated on Nov. 10, 2026 in Healthcare
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Washington state filed an antitrust lawsuit in Thurston County Superior Court against DaVita and Fresenius Medical Care, accusing them of suppressing competition for kidney specialists. The complaint challenges the companies' alleged practice of requiring nephrologists to sign noncompete agreements when serving as dialysis medical directors.
Why it matters
Medicare regulations require dialysis centers to have medical directors, and the state alleges the noncompetes make it harder to hire the doctors needed to open competing centers. Parts of Washington have only one dialysis provider, so the outcome could affect patient choice in those areas.
DaVita operates 51 dialysis centers in Washington and Fresenius operates 29, with DaVita's largest shareholder, Berkshire Hathaway, holding about a 45% stake. The complaint seeks to void noncompete agreements for all current and former medical directors and civil fines of up to $7,500 per violation, while the case's outcome remains unresolved.
The players
DaVita
DaVita is a Denver-headquartered kidney care company that operates dialysis centers across the United States.
Fresenius Medical Care
Fresenius Medical Care is a German-based dialysis and kidney care provider with operations in Washington state.
Federal Trade Commission
The Federal Trade Commission is the U.S. federal agency responsible for enforcing antitrust and consumer protection laws.
The details
The complaint alleges violations of the Washington Consumer Protection Act and the Washington Noncompetition Covenants Act and asks the court to void the noncompete agreements covering all current and former medical directors. The Federal Trade Commission has separately been investigating the companies' use of such agreements since April 2024.
Timeline
April 2024: The FTC began investigating noncompete agreements and issued civil investigative demands.
November 10, 2026: Washington filed the antitrust lawsuit against DaVita and Fresenius.
Market Landscape
The case applies Washington's Noncompetition Covenants Act to physician medical director roles, a relationship that federal Medicare rules make mandatory for dialysis centers. It arrives as the Federal Trade Commission pursues its own investigation into the same practice, signaling sustained scrutiny of noncompetes in specialized healthcare markets.
Patients in parts of Washington with only one dialysis provider may see whether competition improves if the noncompetes are voided. Nephrologists serving as medical directors may gain freedom to work for other centers if the court grants the requested relief.
The takeaway
Noncompete terms in specialized medical roles can shape which dialysis providers patients have access to, and the outcome of this lawsuit may clarify how such agreements are treated under Washington law.
Further reading
For related coverage, see Healthcare in the Washington business section.
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