Judge prevents ProMedica from ending insurance contracts with McLaren St. Luke's

Listen

A federal judge granted a preliminary injunction Dec. 29 to stop Toledo, Ohio-based ProMedica from terminating its insurance contracts with McLaren St. Luke's Hospital, a 300-bed facility in Maumee, Ohio, and its physician group.

The injunction comes in an antitrust lawsuit filed in November by McLaren St. Luke's and WellCare Physicians Group.

The plaintiffs sued after ProMedica's insurance subsidiary, Paramount, notified Grand Blanc, Mich.-based McLaren Health Care that it would terminate insurance contracts with McLaren St. Luke's and its physicians on Jan. 1, 2021. The contract termination would revoke the hospital's in-network status for ProMedica's commercial and Medicare Advantage health plans. The lawsuit claims the termination notice came on the heels of McLaren acquiring St. Luke's Hospital. 

In the lawsuit, McLaren claims ProMedica conducted "monopolistic and anticompetitive behavior designed to maintain and increase its dominant market position by limiting patient choice and causing harm to St. Luke's and its affiliated physicians."

The lawsuit also alleges ProMedica terminated eight long-standing service agreements with McLaren St. Luke's and WellCare, pressured ProMedica surgeons to stop practicing at St. Luke's, and ended its Michigan hospitals' agreements with the McLaren Health plan. 

In granting the injunction, U.S. District Judge Jack Zouhary said McLaren St. Luke's and WellCare established sufficient evidence to support "at least an attempted monopolization claim." 

"Defendants are enjoined from terminating the two contracts at issue between Paramount and plaintiffs until further order of this Court. Defendant shall promptly notify all appropriate Paramount customers of this change," the judge wrote in the injunction. 

On Dec. 4, ProMedica asked the federal judge to dismiss the antitrust lawsuit. That motion has been denied. 

ProMedica said in a statement to the Toledo Blade that it plans to appeal the judge's decision

"In the interim, ProMedica intends to comply with the court's order. We are currently in the process of informing all affected health insurance members and remain committed to helping our members access the highest quality of care to improve their health and wellbeing," ProMedica's statement reads, according to the Blade. 

McLaren St. Luke's called the ruling a "victory for Paramount health plan members and our entire community."

"Now more than ever, our area needs strong hospitals and patients deserve a choice in where they receive care. We are confident today's ruling will be upheld and McLaren St. Luke's will once again be able to care for the thousands of individuals and families who rely on our hospital and its dedicated physicians and caregivers," McLaren said in a statement obtained by Becker's. 

 

© Copyright ASC COMMUNICATIONS 2021. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Featured Whitepapers

Featured Webinars