OhioHealth agrees to void contracts that allegedly punished payers for including competitors in-network

An antitrust lawsuit against a nonprofit health system in Ohio has been resolved in a settlement, where certain reimbursement contracts with healthcare payers will be voided.

The U.S. Department of Justice (DOJ) all but claimed victory in a press release, detailing how OhioHealth will no longer be able to impose “terms in its contracts with commercial health insurers that deter budget-conscious healthcare plans that would lower costs for Ohio consumers and employers.”

Authorities alleged that the system of 16 hospitals and 200 care sites used its market advantage in certain areas to leverage insurance companies and health plans into including its locations in networks, even when competitors offered cheaper prices for the same services.

In February when the lawsuit was filed, OhioHealth told HealthExec that it had been “cooperating with the DOJ throughout its review” of the managed care agreements it had with payers, adding that it was “committed to full compliance with all applicable laws and regulatory requirements.”

Notably, in agreeing to the settlement to void many of those contracts, the organization—which is headquartered in Columbus, the city central to the DOJ’s antitrust complaint—does not admit to wrongdoing.

All the same, the health system is forbidden from pursuing the same contracts in the future, meaning that healthcare payers will be free to effectively exclude OhioHealth from in-network agreements when other organizations offer a more competitive rate for patient care.

To authorities with the state and federal government, this concession is enough to satisfy their mission of restoring market competition.

“As I stated when we filed this lawsuit, healthcare competition is critical,” said Acting Assistant Attorney General Omeed A. Assefi of the DOJ’s antitrust division. “This settlement will secure lower healthcare costs for Ohioans, and ending these anticompetitive contract terms will restore competition for patients in the Columbus area.”

OhioHealth stated that it settled with the government to avoid the expense of litigation. It added that the complaint about the network agreements came from regulators, not the insurance companies themselves.

“OhioHealth periodically renegotiates these contracts with various payors in a highly competitive market. Payors have always retained flexibility in designing and offering healthcare plans to meet the needs of employers and consumerism,” the group wrote in a statement. “Notably, no insurer had requested that OhioHealth remove any of the provisions that were the focus of the lawsuit.”