Portuguese hospital operator CUF wins conditional approval to acquire HPA Group

Compass Lexecon assisted CUF – Sociedade Gestora de Participações, S.A. (‘CUF’) during Phase II merger proceedings by the Portuguese competition authority, reviewing CUF’s acquisition of majority control of Hospital Particular do Algarve, S.A. (‘HPA’). The transaction in the private hospital healthcare market was approved, subject to conditions, at the end of January 2026.

Situation

In March 2025, hospital operator CUF notified to the Portuguese competition authority (Autoridade da Concorrência ‘AdC’) an operation by which it would acquire majority control of the HPA Group. HPA has several hospitals and clinics in the Algarve, Alentejo and Madeira Autonomous Region in Portugal, where CUF is not currently present. The AdC opened an in-depth investigation to study the effects of the transaction in more detail, in July 2025.

Our role

Compass Lexecon was hired by CUF to provide economic advice during the AdC’s Phase II investigation. The AdC expressed particular concerns regarding CUF’s negotiating power vis-à-vis insurers and health subsystems, as well as concerns regarding anti-competitive effects in the Algarve region. We submitted an economic report presenting an economic analysis of the concerns identified by the AdC. We also assisted with responses to RFIs and the assessment of possible remedies.

Outcome

The AdC adopted a non-opposition decision, subject to structural and behavioural conditions, at the end of January 2026.

The team

The Compass Lexecon team advising CUF was led by Jorge Padilla and Bernardo Sarmento, with assistance from Tania Fernandez, Pedro Pereira, and Leonor Junqueiro.

They worked with a team from Cuatrecasas, including Pedro Marques Bom, Miguel Pena Machete, Antonio Souto Moura, and Mariana Fernandes Cerejo.