What happened
The U.S. Department of Justice's Antitrust Division said Tuesday it filed a proposed settlement to resolve its civil antitrust lawsuit against OhioHealth Corporation over contract restrictions with commercial health insurers.
The agency said the settlement would bar OhioHealth from imposing terms that deter budget-conscious health plans that could lower costs for Ohio consumers and employers. The State of Ohio joined the litigation and the proposed settlement, according to the department.
The case targets what DOJ characterizes as insurer contract provisions that limited lower-cost network designs. The department alleges OhioHealth used market power to require insurers to include OhioHealth in all networks for their commercial insurance products regardless of OhioHealth's prices compared with competitors, leaving purchasers with fewer choices and higher prices.
If approved by the court, the proposed consent judgment would void existing provisions that prohibit or deter insurers from offering innovative and budget-conscious plans or plan features, and would prevent OhioHealth from seeking or obtaining similar provisions in the future. It would also bar OhioHealth from penalizing or threatening insurers for offering those plans.
The proposed judgment would appoint a monitor for a five-year term and require OhioHealth to submit regular compliance reports to the Antitrust Division. DOJ said OhioHealth owns or manages 16 hospitals and outpatient facilities across Ohio.
The settlement still must proceed through the Tunney Act process. DOJ said the proposed settlement and competitive impact statement will be published in the Federal Register, followed by a 60-day public comment period, after which the U.S. District Court for the Southern District of Ohio may enter final judgment if it finds the settlement is in the public interest.