On March 14, 2019, the Portuguese Competition Authority (AdC) initiated an investigation into a sectoral association and five business groups in the private healthcare sector following multiple complaints received in February 2019. The investigation revealed that these entities allegedly coordinated to fix prices and other commercial terms in negotiations with ADSE, the health subsystem for civil servants. They are also suspected of jointly threatening to suspend agreements to pressure the settlement of outstanding invoices from 2015 and 2016.

The AdC conducted unannounced inspections and requested information from the involved companies and third parties under Portuguese Competition Law. On July 29, 2021, the AdC issued a Statement of Objections against the five healthcare groups and the sectoral association, concluding the investigation with sanctions imposed in June 2022.

However, the companies appealed the AdC’s decision to the Competition, Regulation and Supervision Court (TCRS), which led to further legal proceedings. The TCRS dismissed an appeal regarding the treatment of confidentiality claims related to seized electronic correspondence. Subsequently, the Lisbon Court of Appeal (TRL) ruled that the seizure of emails was illegitimate, leading to their removal from the case file and returning the case to the investigation phase.

On June 26, 2025, the AdC issued a new Statement of Objections based on valid evidence still available. This new SO addresses the anti-competitive agreement concerning negotiations with ADSE, allowing the involved companies to defend themselves against the allegations and potential sanctions.

The AdC's findings suggest that the companies coordinated their strategies and negotiating positions from 2016 to 2019, aiming to fix prices and commercial conditions. This conduct potentially enhanced their bargaining power against ADSE, leading to more favorable terms than would be possible in a competitive environment. The coordinated threat or suspension of agreements was designed to restrict access to contracted providers, pushing beneficiaries towards more costly non-contracted options.

The case highlights the serious implications of anti-competitive agreements, which are expressly prohibited under Portuguese Competition Law due to their detrimental effects on consumers and the economy.