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OhioHealth deal signals antitrust pressure on hospital payer contracts. by Bruno Queiroz OhioHealth has agreed to stop using contract provisions that federal antitrust enforcers said restricted insurers' ability to guide patients to lower-cost providers, resolving one of two government healthcare competition cases against the system. The settlement is a notable reminder that, even as enforcement priorities shift more broadly in Washington, healthcare remains a sector where regulators continue to scrutinize contracting practices that may limit price competition. At the center of the dispute were alleged "anti-steering" terms in payer contracts. Enforcers contended those provisions made it harder for insurers to design benefit plans or networks that would encourage patients to choose less expensive rivals. From an antitrust perspective, that kind of restriction can draw attention when a hospital system has enough market leverage to influence how payers build networks and how patients access care. The legal significance goes beyond one health system. The case underscores a familiar but still evolving enforcement theory: contract language that does not explicitly fix prices or exclude a competitor can still be challenged if it allegedly impedes insurers' ability to create lower-cost options. For hospitals, physician groups, and other provider organizations, the lesson is that ordinary-course payer agreements can become antitrust flashpoints when they affect steering, tiering, network design, or incentive structures. For litigators, this settlement is also instructive because it arrives without a merits ruling but still sends a strong signal about where government plaintiffs believe the law reaches. Consent resolutions in this area often shape future investigations by identifying the clauses regulators view as especially problematic and by creating a practical roadmap for subsequent complaints. Defense counsel should expect continued focus on internal communications, market power evidence, and negotiations with commercial payers. In-house counsel and compliance teams should take this as a cue to revisit template provisions in managed-care contracts. Terms affecting steering, narrow networks, tiered products, or cost-comparison tools may warrant fresh review, especially for systems with strong regional positions. Antitrust risk assessments should not be limited to merger activity; they should also cover commercial contracting strategies that may be defensible from a business perspective but vulnerable under a competition lens. More broadly, the OhioHealth resolution shows that healthcare antitrust enforcement remains active where regulators see barriers to lower-cost care. For legal professionals tracking provider-payer disputes, it is another example of how contract drafting, market dynamics, and enforcement priorities continue to intersect in consequential ways. Posted in: Docket Alarm is an advanced search and litigation tracking service for the Patent Trial and Appeals Board (PTAB), the International Trade Commission (ITC), Bankruptcy Courts, and Federal Courts across the United States. Docket Alarm searches and tracks millions of dockets and documents for thousands of users.

OhioHealth settles disputed payer contract terms with DOJ. OhioHealth will stop using certain payer contract terms challenged by federal and state antitrust regulators, but admits no wrongdoing and will pay no financial penalty. By Eve Bender, Healthcare Reporter | June 18, 2026 | 11:08 AM OhioHealth's Grant Medical Center Photo: Courtesy OhioHealth OhioHealth has reached a proposed settlement with the Department of Justice and the Ohio Attorney General's Office to resolve an antitrust lawsuit challenging language in some of the health system's managed care contracts. The Justice Department said the agreement would stop OhioHealth from imposing contract terms that deter commercial insurers from offering lower-cost health plan designs, including plans that steer members toward certain providers based on cost, quality or network design. If approved by the court, the proposed final judgment would void existing provisions that prohibit or penalize steering, steered plans, or price and quality transparency, and would prevent OhioHealth from seeking similar terms in future payer contracts. "Tuesday's settlement is a significant win for the Department of Justice, which is clearly very interested in pursuing anti-competitive hospital contracting cases like this as a tool to help lower prices and increase competition in health care," Isaac Kabrick, a fellow at Georgetown's Center for Health Policy and the Law, told Healthcare Finance News. Kabrick said other dominant hospital systems will likely review their payer contracts in light of the agreement. "The settlement agreement includes examples of disfavored contract terms, which could serve as a point of comparison for other hospital systems seeking to remain in compliance with antitrust laws." OhioHealth said the agreement ends litigation over language in certain managed care contracts but does not include an admission of wrongdoing. The health system told Healthcare Finance News in a statement that it "maintains their contracting practices were and are lawful and appropriate" and will not pay penalties, fines or damages. The contract provisions at issue date back as far as two decades and were designed to protect OhioHealth from insurer practices that were common at the time, the health system said. OhioHealth also said payers "have always retained flexibility in designing and offering healthcare plans to meet the needs of employers and consumers," and said no insurer had asked the system to remove the provisions that became the focus of the lawsuit. The Justice Department and Ohio Attorney General's Office sued OhioHealth in February, alleging the system used its market power to restrict payer plan designs in the Columbus area. The complaint alleged OhioHealth required insurers to include OhioHealth in all networks for their commercial insurance products, regardless of how its prices compared with competitors, and that the restrictions limited patients' and employers' access to lower-cost plan options. OhioHealth is a not-for-profit, faith-based health system based in Columbus. The system said it includes 16 hospitals, three joint-venture hospitals, one managed-affiliate hospital, more than 200 ambulatory sites and other health services across a 50-county area. WHY THIS MATTERS For payers and employers, the settlement could affect the design of lower-cost commercial health plans in central Ohio. The proposed agreement would protect insurers' ability to use plan tools such as narrow networks, tiered networks, site-of-service steering, reference-based pricing and centers of excellence, as long as those tools do not violate the final judgment. The proposed agreement would also allow payers to share certain price, cost, quality and patient experience information with members or employers. The DOJ said the contract provisions at issue left purchasers of health insurance with fewer choices and higher prices. The agreement does not immediately end the court process. Under the Antitrust Procedures and Penalties Act, commonly known as the Tunney Act, the proposed settlement and competitive impact statement must be published, followed by a 60-day public comment period, before the court decides whether to enter the final judgment. The U.S. District Court for the Southern District of Ohio may enter the final judgment if it finds the agreement is in the public interest. The proposed final judgment would appoint a monitor for five years and require OhioHealth to submit regular compliance reports to the Antitrust Division. Unless extended, the judgment would expire after 10 years, though it could be terminated after five years if the United States determines it is no longer necessary or in the public interest. THE LARGER TREND The settlement comes as federal antitrust officials are scrutinizing payer contracting practices by large hospital systems. In February, the DOJ and the Ohio Attorney General sued OhioHealth over alleged anticompetitive contract restrictions. In March, the DOJ sued NewYork-Presbyterian Hospital over similar allegations that the system used contract restrictions to limit lower-cost health plan designs. The Antitrust Division has also previously targeted anti-steering provisions in hospital contracts. In 2018, Atrium Health agreed to settle a DOJ antitrust lawsuit challenging steering restrictions in contracts with commercial insurers. Email the writer: [email protected]

OhioHealth settles antitrust suit with the DOJ. OhioHealth has agreed to void problematic contracts with insurers and not seek such terms moving forward, the Justice Department said. The Ohio nonprofit continues to deny all wrongdoing. Published June 17, 2026 Dive brief: * OhioHealth has reached a proposed settlement with state and federal regulators over allegations that the Columbus, Ohio-based system strong-armed insurers into anticompetitive contracts. * The deal announced Tuesday voids problematic OhioHealth contracts and prevents the system from seeking such terms in the future, according to the Department of Justice. * OhioHealth, which has maintained its contracting practices are legal, did not have to admit wrongdoing as part of the settlement. The system also will not pay any penalties or fines. Dive insight: The DOJ and Ohio's attorney general sued OhioHealth in February, accusing the regional nonprofit of leveraging its market dominance to force insurers to include its providers in their networks - even if those providers were costlier than competitors. As a result, OhioHealth was able to get away with charging higher prices than other systems, especially in the Columbus metropolitan area, where the system controls a large swath of acute care services, the DOJ said. The suit sought to block OhioHealth from enforcing those contract provisions and from retaliating against insurers that attempted to introduce more "budget-conscious" plans - terms that the system agreed to in Tuesday's settlement. The deal also appoints a monitor to ensure OhioHealth's compliance over the next five years. "Providing affordable healthcare to Americans is uncontroversial and this Department of Justice will not tolerate corporate prioritization of revenue in contravention of our antitrust laws," Stanley Woodward, the U.S. associate attorney general, said in a statement. OhioHealth said it agreed to the settlement to avoid the costs of drawn-out litigation. No insurer has ever taken issue with the contract language in question, which dates back two decades and was designed to protect the system from "specific insurance company practices common at the time," the system said in a press release. But "since then, both the healthcare and insurance landscapes have changed," OhioHealth acknowledged. The settlement is proposed and still needs to be approved by Ohio's southern district court. OhioHealth operates 16 hospitals in the state in addition to outpatient facilities, physician groups and other clinics. Unlike some of its regional nonprofit peers, OhioHealth has recently posted relatively high operating margins, including a 10% margin in its 2025 fiscal year. That's compared to an average nonprofit hospital margin of 1.1%, according to Fitch Ratings. Under the Trump administration, federal regulators have revitalized interest in scrutinizing contracts between payers and providers that they believe stymie cost-effective healthcare plans. In March, the DOJ filed a suit against NewYork-Presbyterian over alleged anticompetitive restrictions in the New York City-based hospital system's contracts with insurers. That focus at the federal level was last seen in 2016, when the DOJ sued Carolinas HealthCare System, now Atrium Health, over the system's contracting practices with insurers, according to law firm Morgan Lewis. Still, there have been high-profile instances of settlements over "all or nothing" contracts in the states, including one between Sutter Health and California regulators in 2019.