Senator Demands FTC Release Findings of Probe Into For‑Profit Dialysis 'Duopoly'

A senior U.S. senator has pressed federal regulators to publish the results of an investigation into the dialysis industry, where critics say two companies now dominate the market and may be compromising patient care.

Senator Seeks Answers From FTC

Sen. Richard Blumenthal (D-Conn.) has urged the Federal Trade Commission to disclose the results of its probe into the dialysis industry and to take "robust enforcement action" if necessary. In a letter to FTC Chairman Andrew Ferguson, Blumenthal said the current market structure shows "the hallmarks of unlawful abuse of market power" and warned that regulators have not used all available tools to protect patients.

How Concentrated Is the Market?

A CBS News investigation earlier this year found that two companies—Fresenius and DaVita—now own nearly 75% of U.S. dialysis clinics, roughly 5,600 locations. Economists and critics describe the sector as moving toward a duopoly over several decades, making it one of the most concentrated health-care subsectors in the country.

Patients and Veterans at Risk

About 500,000 Americans depend on dialysis to survive while waiting for a kidney transplant. Blumenthal highlighted that roughly 40,000 veterans are among those who rely on these clinics. The senator wrote that the FTC should ensure enforcement steps protect vulnerable populations, including veterans, from any misconduct by dominant providers.

Allegations and Data

A CBS News review of federal data reported that about one-third of dialysis clinics—nearly 2,500 of roughly 7,600 nationwide—failed to meet federal standards this year, with an average compliance score of 60 out of 100. Since 2013, Centers for Medicare & Medicaid Services (CMS) surveyors have recorded more than 115,000 deficiencies at U.S. dialysis centers, including lapses such as poor hand hygiene, unsanitary handling of IV medications, and inadequate staff training.

"This is emergency room care done in the mall," said Tom Mueller, author of How to Make a Killing: Blood, Death and Dollars in American Medicine, after five years of studying the industry. "People are not given the tailored treatment that they need."

Duke economist Ryan McDevitt, who has analyzed the market, said that Medicare reimbursement limits may create incentives for large providers to maximize chair utilization rather than individualized care. McDevitt's research indicates that when independent clinics are acquired by DaVita or Fresenius, transplant referrals fall by about 10%, patient survival drops by roughly 2%, hospitalizations increase by around 5%, and infection rates rise by about 12%.

Industry Response

Both companies dispute the criticisms. Fresenius said it maintains an "unwavering focus on improving quality of life, strengthening clinical outcomes, and extending the lifespan" of patients. The company noted that more than 65% of its centers received three stars or higher on Medicare's five-star scale—a rate it says is above the national average for dialysis providers.

DaVita told CBS News that problems are "rare and isolated" and called characterizations of systemic failure "reckless" and potentially harmful to patient well-being. Last year, DaVita reported delivering more than 29 million dialysis treatments at an average revenue of roughly $391 per session; combined revenue for the two companies reached about $33.7 billion.

What Comes Next

Blumenthal has asked the FTC to be transparent about any findings and to take enforcement actions to protect patients if the probe identifies anti‑competitive or harmful practices. The FTC said it is investigating, and Fresenius confirmed it is cooperating; both the FTC and DaVita did not immediately provide further comment to CBS News.

Experts say the outcome of the probe could affect regulatory oversight, potential enforcement actions, and broader policy debates about consolidation in health care and how payment systems shape provider behavior.