New ACCC merger regime: What medical and allied health practice executives must know

On 1 January 2026, buying another practice became more complicated.

Australia moved to a mandatory ACCC (Australian Competition and Consumer Commission) approval system for mergers and acquisitions.

If your acquisition meets certain revenue thresholds, you now must get ACCC approval before you complete the deal.

This is a complete shift from the former “informal” system.

What is changing?

Before 31 December 2025: Review was informal and voluntary.

From 1 January 2026: acquisitions meeting the thresholds cannot complete without ACCC approval. There is now no ability to “complete first and deal with ACCC later.”

When do you need ACCC approval?

You must notify ACCC (and obtain clearance before completion) if your acquisition meets either of the following thresholds below:

Threshold 1: Large combined groups ($200M+ combined revenue)

You must notify if:

• the acquirer group and the target group together have $200 million or more in Australian revenue, and
• any one of the following applies:
  • the target group has $50 million or more in Australian revenue, or
  • the global transaction value is over $250 million, or
  • the cumulative Australian revenue from similar acquisitions of the acquirer group over the last 3 years totals $50 million or more.

Threshold 2: Very large acquirers ($500M+ acquirer revenue)

You must notify if:

• the acquirer group earns $500 million or more in Australian revenue, and
• either:
  • the target group earns $10 million or more in Australian revenue; or
  • the cumulative Australian revenue from similar transactions of the acquirer group over three years totals $10 million or more.

Why this matters for healthcare groups

These rules are designed to capture serial roll-up strategies, commonly used in general practice, dental, pathology, imaging, allied health, and specialist networks – even where each practice is relatively small on its own. The cumulative test can aggregate individual acquisitions when looked at together over time.

Practical examples for healthcare groups

Example 1: Dental group roll-up strategy Australian Dental Partners (hypothetical, $520 million revenue) acquires 3-5 practices annually. Each practice generates $3-6 million revenue. Under the new regime, acquiring a $12-million practice triggers mandatory notification under Threshold 2 (acquirer over $500 million, target over $10 million). Even an $8 million acquisition may trigger notification if cumulative acquisitions over three years exceed $10 million.

Example 2: Medical practice consolidation Primary Health Network (hypothetical, $180 million revenue) acquires Regional Medical Group ($25 million revenue). Combined revenue is $205 million, but the target is under $50 million and cumulative similar acquisitions are $40 million, therefore no notification is required yet. The next $15 million acquisition within 3 years will hit the $50 million cumulative threshold, requiring ACCC approval under Threshold 1 (acquirer over $200 million, cumulative similar revenue over $50 million).

Example 3: Specialist practice acquisition A private equity-backed pathology group ($600 million revenue inclusive of the revenue of PE group) acquires a diagnostic imaging practice ($9 million revenue). No notification required (target under $10 million threshold). However, if this is the fifth similar acquisition in three years totalling $11 million cumulatively, mandatory notification applies under Threshold 2 (acquirer over $500 million, cumulative similar revenue over $10 million).

The creeping acquisition risk

The ACCC adds together similar acquisitions over the previous 3 years when testing cumulative thresholds.

For healthcare, this will generally capture:

• all general practice acquisitions;
• all dental practice acquisitions within a dental group;
• specialist medical practices in the same field; and
• potentially allied health services to the extent the services are substitutable.

Revenue is broader than you think

Australian revenue is gross revenue attributable to transaction or assets within Australia, calculated for the most recent 12-month reporting period. Revenue is aggregated across all "connected entities" including:

• parent companies;
• subsidiaries (entities under common control);
• Entities under common control by common parent.

For PE-backed or multiple entity practice, the whole group is aggregated.

Process requirements

Pre-notification engagement (strongly recommended):

• Contact ACCC at least 2 weeks before formal filing (earlier for complex or competition-sensitive deals)
• Discuss appropriate notification form (short vs. long)
• Align on information requirements and timing.

Notification requirements (post 1 January 2026):

• Notification is mandatory (if thresholds met)
• A notification waiver may be available for straightforward, low-risk acquisitions
• Completion is prohibited until ACCC approval is granted
• All filings go through an online ACCC portal.

Practical implications for healthcare transactions

Transaction documentation:

• Include ACCC clearance or waiver as condition precedent
• Build in notification timelines within exclusivity, financing and longstop dates
• Address which party bears notification costs and prepares materials.

Due diligence scope:

• Competition analysis becomes critical early in process
• Market definition exercises required
• Geographic overlap assessment essential
• Customer/patient overlap analysis.

Strategic planning for roll-ups:

• Track your three-year acquisition history now
• Model future deals to test cumulative thresholds
• Consider sequencing and timing to manage threshold triggers and deal value.

Immediate actions required

1. Calculate your position: Does combined Australian revenue equal or exceed $200 million, or does the acquirer group equal or exceed the $500 million threshold?
2. Audit acquisition history: Identify similar acquisitions over the past three years in healthcare services (excluding transactions less than $2 million and already notified/approved deals)
3. Review pipeline: Identify which planned 2026 acquisitions will trigger target or cumulative notification thresholds
4. Update processes: Revise acquisition playbooks to incorporate mandatory ACCC approval
5. Engage advisors: Ensure legal and corporate finance teams understand new requirements.

The bottom line

On 1 January 2026, growth by acquisition in healthcare became a regulated activity.

Groups that prepare early, by mapping their cumulative acquisitions, building realistic timetables, and engaging with the ACCC, can still execute roll-ups smoothly.

Groups that ignore the change risk:

• deal delays,
• failed acquisitions, and
• regulatory penalties.

Need help assessing your notification obligations or preparing for the new regime?

If you have any questions or would like more information about how we can assist you or your business, please contact our M&A team on 1800 867 113 for a confidential consultation, or click here to arrange a discussion at a time that suits you.