Atrium settles antitrust lawsuit over health plan contracts: 6 things to know

Charlotte, N.C.-based Atrium Health has agreed to a settlement with the Department of Justice that prohibits the health system from enforcing anticompetitive steering restrictions in contracts between payers and its providers, according to the Department of Justice.

Here are six things to know:

1. The Justice Department filed a civil antitrust lawsuit against Atrium in June 2016, alleging the system drove up healthcare costs in the region by imposing steering restrictions in contracts with commercial health insurers.

2. The lawsuit alleged the system used its market power to require steering restrictions in its contracts with every major insurer in the area. The steering provisions prevented insurers from introducing health plans that encourage patients to use providers that offer more cost-effective care than Atrium, according to the Justice Department.

3. In addition to preventing Atrium from enforcing steering restrictions, the proposed settlement prohibits the system from seeking contract terms or taking other actions that would "prohibit, prevent, or penalize steering by insurers in the future," according to the Justice Department.

4. "The language in question is from contracts created as long ago as 2001 and was originally added to ensure Atrium Health was provided an equal opportunity to compete for patients," Atrium said in a press release. "As the healthcare landscape continues to rapidly evolve, Atrium Health's contracting language has also evolved to reflect current healthcare practices. Throughout the litigation, Atrium Health has shared its perspective and position with the DOJ and the North Carolina Office of Attorney General, and is pleased to be able to reach a mutually acceptable settlement agreement."

5. Atrium, which admitted no wrongdoing in the proposed settlement, is North Carolina's largest health system and includes a network of more than 40 hospitals.

6. "With healthcare costs rising, vigilant antitrust enforcement is an essential tool for protecting consumers," Assistant Attorney General Makan Delrahim said in a press release. "By eliminating restrictions that curb comparison shopping and interfere with competition among healthcare providers, today's resolution of our antitrust action allows consumers in the Charlotte area to benefit from competition when making critically important healthcare choices."

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