Epic Systems, the Wisconsin company whose software holds the medical records of more than 250 million Americans, is defending three separate antitrust lawsuits. The state of Texas, the health data startup Particle Health, and the managed care software firm CureIS Healthcare each allege that Epic has used its dominance in electronic health records to block competitors and restrict access to patient data. As of mid-2026, none of the cases have gone to trial. Particle’s federal Sherman Act claims survived a motion to dismiss in September 2025 and are in discovery; the CureIS case has been transferred to federal court in Wisconsin, where Epic’s motion to dismiss is pending; the Texas case is in state court in Tarrant County, where Epic has filed its answer.
Why Epic Is the Target
Epic’s share of the acute care hospital EHR market reached 42.3% in 2024, up from 31% in 2020, according to KLAS Research.1Fierce Healthcare. Epic Gaining More Ground Hospital EHR Market Share Widens Its Lead Over Oracle Health Among health systems with more than ten hospitals, its share is 48%. Measured by hospital beds, Epic accounts for nearly 55%.2Dark Daily. Epic Expands EHR Market Share as Rivals Lose Customers Every hospital on U.S. News and World Report’s best hospitals list runs on Epic.3Forbes. Epic’s Antitrust Paradox: Who Should Control the Levers of Healthcare Innovation
Between 2017 and 2022, Epic won 79% of net new hospital EHR deals. In 2024 alone it added 176 multispecialty hospitals and took nearly 70% of all hospitals that made a purchasing decision that year.2Dark Daily. Epic Expands EHR Market Share as Rivals Lose Customers Its closest rival, Oracle Health, holds about 23% of acute care and has been losing customers since Oracle bought Cerner in 2022.4EHR in Practice. Largest EHR Vendors Switching costs are steep: a migration off Epic typically runs $50 million to $150 million and takes 18 to 36 months.5EHR Source. Epic vs Oracle Health Those numbers form the factual foundation the plaintiffs all rely on.
Texas v. Epic Systems
Texas Attorney General Ken Paxton filed suit on December 10, 2025 in Tarrant County District Court, case number 236-372872-25.6Texas Attorney General. Petition, State of Texas v. Epic Systems Corporation The complaint uses the Texas Free Enterprise and Antitrust Act, the Texas Deceptive Trade Practices Act, and the Texas Medical Records Privacy Act. It deliberately leaves out any federal Sherman Act claim, a choice that keeps the case out of federal court.7Fierce Healthcare. Texas AG Sues Epic Alleging Company Monopolizes EHR Market, Restricts Parent Access
The Antitrust Allegations
Texas accuses Epic of running an “anticompetitive playbook” that lets it act as a gatekeeper over patient data. The state says Epic interferes with hospitals’ ability to use their own patient data with competing software, holds data “hostage” when clients try to work with competitors, imposes penalty fees on hospitals using rival applications, and blocks or delays record access for providers who do not use its platform.8Wisconsin Public Radio. Texas Sues Wisconsin Based Epic Systems Accusing Monopoly9Source on Healthcare. State of Texas v. Epic Systems: Heightened Scrutiny of Healthcare Market Dominance
The Parental Access Claim
A large part of the Texas complaint concerns Epic’s default settings for minors’ records. Texas alleges that Epic’s software is preconfigured to automatically restrict parents from viewing a child’s medication lists, treatment notes, and provider messages once the child turns twelve.7Fierce Healthcare. Texas AG Sues Epic Alleging Company Monopolizes EHR Market, Restricts Parent Access The state says this violates Texas Health and Safety Code § 183.006, which it reads as giving parents complete and unrestricted access to a child’s medical records.10Texas Attorney General. Attorney General Ken Paxton Sues Major Medical Record Database Gatekeeping Data and Restricting
Texas is seeking a court order to restore competitive conditions in the EHR market, along with injunctive relief, civil penalties, and monetary damages.9Source on Healthcare. State of Texas v. Epic Systems: Heightened Scrutiny of Healthcare Market Dominance
Epic’s Answer
Epic filed its answer on January 20, 2026, denying every allegation and asserting 29 affirmative defenses. It said it would “aggressively litigate this case to its full dismissal.”11Fierce Healthcare. Epic Fires Back Texas AG Lawsuit Argues Anticompetitive Behavior Allegations Are Baseless On the antitrust claims, Epic argues that Texas failed to properly define a relevant product market, that Epic lacks the market power required for a monopolization claim, and that antitrust law does not require it to share its proprietary software with competitors for free. On the parental access claim, Epic says its software is “highly configurable” and that hospitals, as the legal custodians of records, set the access permissions. The company says it proactively gave Texas customers software guides for compliance with the 2025 Texas laws before they took effect.12Healthcare IT News. Epic Challenges Validity of Texas AG’s Antitrust Lawsuit Epic also noted that a six-month civil investigation had “found nothing wrong” and that the state could not point to a single specific instance in which a parent was denied access to a child’s records.13WMTV. Epic Argues Claims in Lawsuit From Texas AG Are Baseless
Particle Health v. Epic Systems
Particle Health filed its federal antitrust suit on September 23, 2024, in the U.S. District Court for the Southern District of New York.14CourtListener. Particle Health Inc. v. Epic Systems Corporation, 1:24-cv-07174 Particle, founded in 2018, aggregates health information through APIs and provides access to more than 300 million patient records. In 2023 it entered the “payer platform” market, building tools that help insurers obtain and analyze medical records.15Healthcare Dive. Epic Particle Health Antitrust Lawsuit
The Carequality Dispute Behind the Suit
In March 2024, Epic filed a formal dispute through the nationwide health data exchange Carequality, alleging that some of Particle’s customers were retrieving records for purposes other than treatment. One customer, Integritort, was accused of using the data to recruit plaintiffs for class actions. Epic suspended its connection with Particle the same day.16CNBC. Epic Systems Boots Particle Health for Unauthorized Sharing of Data17HIPAA Journal. Epic Systems Access Particle Health Patient Privacy Concerns
In October 2024, a Carequality dispute resolution panel imposed a six-month corrective action plan on Particle and barred two of its customers from the network for twelve months. But the panel also found that Particle had performed “sufficient diligence” during onboarding and rejected Epic’s claim that Particle was “masking” the identities of its connections. It ordered Epic to update its own policies with “clear, objective criteria” for deciding whether an organization qualifies for treatment-purpose data access.18Legal HIE. Unmasking the Issues: The Final Resolution in the Epic v. Particle Health Dispute
The Antitrust Claims
Particle’s complaint alleges that Epic used its EHR dominance to suppress competition in the payer platform market. Specifically, Particle says Epic suddenly denied record access for dozens of its customers in March 2024, conditioned restored access on those customers dropping Particle, used its influence over Carequality to force a five-month dispute process, and slowed new customer onboarding from roughly two days to more than a month.15Healthcare Dive. Epic Particle Health Antitrust Lawsuit Particle also alleges that the disruption compromised patient care, citing a community oncology network where clinical information was blocked, affecting more than 2,800 patients.19Healthcare Finance News. Data Startup Particle Health Sues Epic Over Antitrust Concerns
Epic denies the allegations, maintaining its software is “open and interoperable” and that its actions were necessary to protect patient privacy after Particle’s customers violated HIPAA by sharing data for impermissible purposes.19Healthcare Finance News. Data Startup Particle Health Sues Epic Over Antitrust Concerns
The September 2025 Ruling
On September 5, 2025, Judge Naomi Reice Buchwald denied Epic’s motion to dismiss the core antitrust claims, finding Particle had presented “credible information” to back up its claims of anticompetitive behavior.20MedCity News. Epic Particle Data Healthcare Monopoly Three federal antitrust claims and a tortious interference claim survived and are proceeding to discovery, which will focus on whether the payer platform market is a distinct market and whether Epic’s data restrictions were justified.21Wisconsin Public Radio. Federal Antitrust Lawsuit Against Epic Systems Move Forward The judge dismissed Particle’s conspiracy, defamation, and trade libel claims.22STAT News. Epic Particle Health Monopoly Antitrust Discovery EHR No trial date has been set.
CureIS Healthcare v. Epic Systems
CureIS Healthcare, a managed care software company, filed suit against Epic in the Northern District of California on May 12, 2025, alleging a “multi-prong scheme to destroy” its business.23Wisconsin Public Radio. Lawsuit Epic Systems Multi Prong Scheme Destroy Health Competitor CureIS The complaint alleges an “Epic-first policy” that pressures health systems to adopt Epic’s own modules whenever available, misrepresentations that Epic’s products replicate CureIS’s functionality, coercion of shared customers into terminating CureIS contracts, and denial of data access to CureIS customers. It also brings trade secret misappropriation and false advertising claims under the Lanham Act and California law.24Fierce Healthcare. Epic Hit With Lawsuit CureIS Healthcare Alleged Scheme to Destroy Its Business
On November 26, 2025, Judge Maxine Chesney granted Epic’s motion to transfer the case to the Western District of Wisconsin, where Epic is headquartered.25GovInfo. CureIS Healthcare Inc. v. Epic Systems Corporation, Order Granting Transfer Epic has previewed a motion to dismiss in Wisconsin; a briefing schedule is set and discovery has not been stayed.26CourtListener. CureIS Healthcare Inc. v. Epic Systems Corporation, 3:25-cv-00991 (W.D. Wis.)
Epic’s Overall Defense
Across all three cases Epic’s arguments track together. The company says it operates in a competitive market, does not control patient data (hospitals do), actively promotes interoperability, and protects its intellectual property rather than competition. Epic says its customers exchange over 725 million medical records monthly, more than half of that with non-Epic systems, and that more than 1,500 third-party applications connect to its platform through a library of over 500 APIs.12Healthcare IT News. Epic Challenges Validity of Texas AG’s Antitrust Lawsuit
The Federal Enforcement Backdrop
The private and state suits are running alongside a federal push on information blocking. The 21st Century Cures Act prohibits practices by health IT developers, health information networks, or providers that are likely to interfere with access to or exchange of electronic health information without legal justification. Developers found to have engaged in information blocking face civil monetary penalties of up to $1 million per violation and can be banned from the ONC Health IT Certification Program.27HealthIT.gov. Information Blocking Enforcement Alert In September 2025, HHS declared information blocking enforcement a “top priority” under Secretary Robert F. Kennedy Jr., and the ONC and Office of Inspector General issued a joint enforcement alert. No public enforcement actions against named companies had been announced by late 2025.
Noncompetes and the Labor Angle
Epic’s employment practices figure into the broader antitrust narrative even though they are not the direct basis of the three suits. The company requires employees to sign noncompete agreements that typically last one to two years after departure and restrict work at roughly 4,500 named companies, including direct competitors, consulting firms, and Epic’s own hospital customers.28Isthmus. Broad Overreach: Epic Noncompete FTC Comments Critics say the practical enforcement mechanism is credentialing: Epic can deny former employees access to UserWeb, the internal platform required for training, support, and community resources, which effectively locks them out of hospital IT roles that depend on Epic systems. Critics also say Epic pressures consulting firms and hospital clients not to hire former Epic staff by threatening higher software costs or revoked accreditation.29Forbes. Competitive or Exclusionary: Epic’s Seven Anti-Competitive Sins Multiple commenters singled out these practices as “broad overreach” during the FTC’s 2023 public comment period on a proposed national noncompete ban.
Epic as Plaintiff: The Health Gorilla Suit
Epic is not only a defendant. On January 13, 2026, Epic, along with Trinity Health, UMass Memorial Health, Reid Health, and the health IT organization OCHIN, sued Health Gorilla and several of its clients in the U.S. District Court for the Central District of California.30Healthcare IT News. Epic and Health Systems Sue Health Gorilla and Data Companies The complaint alleges the defendants used fictitious websites, shell entities, and fake provider identification numbers to fraudulently access nearly 300,000 patient records through the Carequality and TEFCA interoperability frameworks, then used the data for non-treatment purposes such as marketing to law firms for mass tort litigation.31Healthcare Dive. Epic Health Systems Lawsuit Health Gorilla Improper Medical Records Access Health Gorilla denies the allegations and characterizes the suit as an attempt by Epic to “limit competition and restrict access to healthcare data.”32Fierce Healthcare. Epic’s Lawsuit Against Health Gorilla Raises Broader Issues About Future Data Sharing The dispute mirrors the same fault line that runs through the antitrust suits: whether Epic’s data-access decisions reflect legitimate privacy enforcement or gatekeeping.
What to Watch Next
Discovery in Particle Health will produce the first substantive record of how Epic makes data-access decisions and whether the payer platform market can be defined as a distinct antitrust market. The pending motion to dismiss in CureIS will test whether the “Epic-first” theory survives at the pleading stage in Epic’s home district. And Texas’s decision to stay in state court on state law claims means that case will move on its own track, with Epic already signaling it will seek dismissal after filing its answer.11Fierce Healthcare. Epic Fires Back Texas AG Lawsuit Argues Anticompetitive Behavior Allegations Are Baseless