The Antitrust Division and the U.S. Attorney's Office for the Southern District of New York filed the complaint in the U.S. District Court for the Southern District of New York, charging New York-Presbyterian with violating Section 1 of the Sherman Act. New York-Presbyterian is the largest and most powerful hospital system in New York City, owning and operating eight hospitals and many outpatient facilities in the New York City area.
According to the complaint, New York-Presbyterian imposes plan restrictions in its contracts with payors that prevent payors from offering plans that do not include New York-Presbyterian or do not feature New York-Presbyterian in the most favored tier of the plan. The hospital system also forbids payors from offering lower copays when patients choose to receive care at New York-Presbyterian's rivals, which are often lower priced.
The Justice Department alleges these restrictions insulate New York-Presbyterian from price competition, limit rival hospitals from competing for patients based on lower prices or better value, and prevent the development of budget-conscious plans for New Yorkers that are available in other parts of the United States.
"Millions of New Yorkers pay more for healthcare because of these anticompetitive practices," said Attorney General Pamela Bondi. "At the direction of President Trump, this Justice Department will fight relentlessly to ensure that Americans get the healthcare they need without facing exorbitant costs."
Acting Assistant Attorney General Omeed A. Assefi of the Antitrust Division said "New York-Presbyterian has known for years that the American consumer wants budget-conscious health plans that reduce healthcare costs. But rather than offer consumers choice, New York-Presbyterian uses its market power to protect its margins, impede competition from rival hospitals, and prevent employers and unions from creating these plans."
The lawsuit seeks to enjoin New York-Presbyterian from imposing contractual restrictions that preclude insurers and employers from offering New Yorkers budget-conscious health insurance plans. This is the second case the Division has brought this year to ensure that Americans can access healthcare markets with robust competition.