The contract restrictions prevent consumers from choosing lower-cost health plans, lawsuit says.
The Department of Justice is suing OhioHealth for alleged anticompetitive contract restrictions.
The DOJ’s Antitrust Division and the Attorney General of Ohio filed the civil antitrust lawsuit on Feb. 20 in federal court in the Southern District of Ohio.
In its complaint, the DOJ wants the court to prevent OhioHealth Corp. from enforcing its anticompetitive contractual terms that it claims suppress healthcare competition. OhioHealth’s contract terms force Ohio patients to pay higher prices for healthcare, according to the DOJ.
OhioHealth is the largest healthcare system in Ohio, according to the DOJ. The health system owns or manages 16 hospitals and outpatient facilities throughout the state.
“OhioHealth is the dominant hospital system in Columbus,” the complaint said. “Since at least 2003, it has used its market power to protect its dominance – and its high prices – by blocking payers from offering patients health insurance plans that feature lower-cost hospitals and other providers and even from informing patients that lower-cost options are available.”
WHY THIS MATTERS
OhioHealth uses its market power to impose contractual restrictions that impede or completely prevent insurers from offering money-saving health-insurance plans or plan features, according to the complaint.
OhioHealth generally forces insurers to include OhioHealth in all of the networks for the commercial insurance products they offer, regardless of how OhioHealth’s prices compare with those of its competitors, preventing the development of budget-conscious plans in the Columbus area, the complaint said.
Patients and employers are faced with fewer health plan choices and higher costs, the DOJ said.
OhioHealth released this statement: “OhioHealth has been cooperating with the Department of Justice throughout its review of our managed care agreements. We are confident in our position and remain committed to full compliance with all applicable laws and regulatory requirements. As this is active litigation, we will not comment on specifics beyond what has been publicly disclosed.”
THE LARGER TREND
OhioHealth is the dominant hospital system in the Columbus, Ohio, area, the complaint said. It competes with the Ohio State University Wexner Medical Center and also with the Mount Carmel Health System, which is owned by Trinity Health, according to the court documents.
Mount Carmel operates five hospitals in the Columbus area and holds a majority joint-venture interest in a sixth.
ON THE RECORD
“Americans deserve low-cost, high-quality healthcare – not anticompetitive hospital system contracts that make healthcare less affordable,” said Attorney General Pamela Bondi. “Under President Trump’s leadership, this Department of Justice will continue taking legal action to protect consumers and drive down healthcare costs across America.”
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