Columbus-based OhioHealth is seeking the dismissal of the Justice Department’s antitrust lawsuit against the system, arguing the lawsuit is too vague to proceed and misreads how competition in healthcare markets actually works.
Four things to know:
1. The Justice Department and the state of Ohio on Feb. 20 filed a lawsuit against OhioHealth, alleging the system used anticompetitive contract provisions to drive up healthcare costs for patients and employers in central Ohio.
The complaint accuses OhioHealth of imposing contractual restrictions on commercial payers that prevented them from offering lower-cost, “budget conscious” health plans. The lawsuit seeks to block the system from enforcing contract provisions that restrict insurers from offering plans that provide financial incentives or information encouraging members to use competing providers. It also seeks to bar the system from retaliating against insurers that attempt to introduce such plans.
2. The 16-hospital system argued in a May 8 court filing that the government failed to identify which insurers entered the alleged agreements, when those agreements were signed, how long they lasted, or what specific contract language is at issue.
“OhioHealth and the court are left to guess the who, when, where, what, and how of the alleged anticompetitive agreements,” the system said in the filing.
3. OhioHealth also argued its 35% market share in a three-system Columbus market falls well below the threshold courts — including the Supreme Court — have generally required to establish antitrust liability, citing precedent rejecting market power claims below 50%.
4. The system also contends the contract provisions at issue — which require insurers to include OhioHealth in networks at preferred benefit tiers — are standard antisteering clauses that the Supreme Court ruled as “not inherently anticompetitive.”
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