CADE launches administrative enquiry to impose preventive measure in paediatric surgery market

On 20 May, the Office of the Superintendent General at CADE (SG) launched an administrative enquiry against Serviços Cirúrgicos Pediátricos (SECIPE), based in Campo Grande, in the Brazilian state of Mato Grosso (MS), to investigate an alleged antitrust violation in the market for paediatric surgery services.

The investigation began following a complaint against SECIPE, stating that the company concentrated most of the qualified paediatric surgeons in the region, and operated as a centralised structure in negotiations with hospitals and health insurance providers. The preliminary investigation found evidence that SECIPE may have been used to centralise the market conduct of professionals who, in principle, should operate independently.

According to CADE, the evidence collected so far indicates a possible collective price-fixing of medical fees through the use of a fixed fee schedule and centralised negotiations with healthcare market players.

The authority considers the affected market to be sensitive, since it involves specialised medical services that are difficult to substitute and are often related to emergency hospital care. The SG highlighted that paediatric surgeries have a direct impact on hospitals, health insurance providers, and patients.

Given the evidence, the agency decided to adopt a preventive measure to suspend practices that may affect competition in the market under investigation. Under the measure, SECIPE must refrain from preparing or disclosing medical fee schedules, directly or indirectly participating in collective or individual negotiations concerning the medical services provided by professionals within its corporate structure or by outsourced service providers, and directly or indirectly preventing doctors from negotiating with hospitals, health insurance providers, or other entities in the sector.

The preventive measure is provided for under Law 12529/2011 and may be imposed whenever there is evidence that the investigated conduct may cause irreparable damage to the market, damage that is difficult to repair, or that may render the outcome of the proceedings ineffective.

Now, the SG is to continue the investigation to further examine SECIPE’s conduct, existence and contents of any fee schedules, the company’s level of affiliation with paediatric surgeons, real possibility of individual contracting, and possible existence of formal or informal restrictions on independent negotiations.

Finally, the SG will issue a final report and recommend either the dismissal of the case or the launch of an administrative sanctioning proceeding against the respondent.

Access Case no. 08700.011857/2025-36.