The Department of Justice's Antitrust Division, alongside Ohio Attorney General Dave Yost, has filed a civil antitrust lawsuit against OhioHealth Corp., alleging the hospital system used its dominant market position to block insurers from offering lower-cost and innovative health plans to employers and consumers.
The complaint, filed in the U.S. District Court for the Southern District of Ohio, seeks to enjoin OhioHealth from enforcing what regulators describe as anticompetitive contractual provisions that suppress health care competition in the Columbus region.
OhioHealth is a large not-for-profit, faith-based health care system headquartered in Columbus, Ohio. It operates 16 hospitals and more than 200 outpatient facilities across roughly 50 counties. The system is described in the complaint as the dominant hospital provider in central Ohio, competing primarily with Ohio State University Wexner Medical Center and Mount Carmel Health System.
According to the lawsuit, OhioHealth requires insurers that include the system in their networks to include all of its hospitals and providers in every commercial product. The complaint also alleges the contracts restrict insurers from offering budget-conscious plan designs, such as narrow or tiered networks, and limit insurers' ability to provide consumers with price information — sometimes referred to as "gag clauses."
Regulators argue these provisions prevent insurers from designing plans that steer patients to lower-cost providers, restrict price transparency, and reduce competitive pressure that could otherwise lower premiums and out-of-pocket costs for employers and employees.
"This lawsuit challenges anticompetitive contract restrictions that prevent consumers from choosing lower-cost health plans and severely limit consumers' access to price information," said Acting Assistant Attorney General Omeed A. Assefi of the Justice Department's Antitrust Division. "These restrictions cause many Columbus residents to pay more for lower-quality health care. American families and consumers deserve better."
The government alleges OhioHealth's conduct violates Section 1 of the Sherman Act, which prohibits unreasonable restraints of trade, as well as Ohio's Valentine Act, the state's antitrust statute. The complaint contends the contract provisions unlawfully protect OhioHealth's pricing power and prevent rival health systems from competing on price and quality.
The DOJ and Ohio are asking the court to bar OhioHealth from enforcing the disputed contractual restrictions and to restore competitive contracting practices that would allow insurers to offer a broader range of plan designs. Specific remedies would be determined later in the litigation process.
In response, OhioHealth said it has been cooperating with the Justice Department during its review of the system's managed care contracting practices and remains committed to complying with applicable laws and regulatory requirements. The health system declined to comment on the specific allegations.
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