DOJ Settles Lawsuit Alleging Hospital Contracts With Insurers Unlawfully Excluded Healthcare Provider Competition

On June 16, 2026, the Antitrust Division of the U.S. Department of Justice filed a proposed settlement resolving a civil antitrust lawsuit brought by DOJ and the state of Ohio against OhioHealth, a Columbus, Ohio-based not-for-profit hospital system. The proposed settlement was announced four months after DOJ filed its complaint. The complaint alleged that OhioHealth’s 35% market share of inpatient general acute care services in Columbus made it a “must have” participant in private insurance networks, and that OhioHealth used that market power to require commercial payors to include OhioHealth in all of their plans and to feature OhioHealth at the “most favored” benefit level in each network. 

According to the complaint, these contractual requirements had the practical effect of foreclosing lower-cost providers from competing for approximately 85% of the private insurance business in the Columbus area. The proposed settlement prohibits OhioHealth from enforcing the challenged contract provisions, requires OhioHealth to notify payors that such provisions are void, and subjects OhioHealth to oversight by DOJ and the Ohio Attorney General for the 10-year term of the proposed final judgment.

DOJ’s Allegations

On Feb. 20, 2026, DOJ filed a complaint against OhioHealth alleging that its contracts with commercial payors in the Columbus area had effectively foreclosed competition from lower cost providers. Specifically, the complaint alleges that “OhioHealth restricts payors from offering budget-conscious plan designs that promote competition among healthcare providers by effectively forcing them to include OhioHealth in all networks for all commercial insurance products, regardless of how OhioHealth’s prices compare to its competitors, and requiring that OhioHealth be featured at the most favored level of benefits in each network.”

DOJ also challenged contract provisions that allegedly restricted payors’ ability to communicate to patients the cost of healthcare services available under a plan, which DOJ contends further dampened competition among providers. 

DOJ alleged that OhioHealth was able to impose these provisions on payors because of its market power. According to the complaint, OhioHealth held more than 35% of inpatient acute general care discharges and beds in the Columbus area and also “derive[d] market power from its control of hospitals outside of the Columbus MSA, some of which are the only hospitals in their counties.” 

Settlement Terms

In a statement announcing the settlement, OhioHealth noted that the challenged contractual restrictions dated back as far as “two decades” and were the product of renegotiation over the years in a “highly competitive market.”

To resolve the allegations, on June 16, 2026, the parties submitted a proposed settlement that would:

• Void OhioHealth’s existing challenged contractual restrictions;
• Prohibit OhioHealth from including such provisions in future contracts;
• Prohibit OhioHealth from penalizing health insurers that offer budget-conscious health-insurance plans; and
• Permit the government to request a court-appointed monitor at OhioHealth’s expense for a five-year term, with OhioHealth also required to submit compliance reports to the Antitrust Division throughout the 10-year term of the proposed final judgment.

Under the Tunney Act, the proposed settlement and an accompanying competitive impact statement will be published in the Federal Register. Interested persons may submit written comments regarding the proposed settlement within 60 days of publication. Following the comment period, the U.S. District Court for the Southern District of Ohio will determine whether the proposed settlement is in the public interest and, if so, may enter it as a final judgment.

Key Takeaways

1. This matter is one of two new civil antitrust “exclusive dealing” conduct cases brought by DOJ against a hospital system. The other lawsuit involves similar allegations and remains pending. Together, these lawsuits reflect DOJ’s continued focus on competition in the healthcare industry and its willingness to pursue litigation to challenge conduct it views as anticompetitive.
2. Although OhioHealth reached a settlement shortly after the complaint was filed and neither admitted wrongdoing nor paid monetary penalties, the proposed settlement imposes significant ongoing obligations: OhioHealth is prohibited from enforcing the challenged contract provisions and will be subject to oversight by DOJ and the state of Ohio for 10 years. OhioHealth also faces the prospect of a court-appointed outside monitor at its own expense, which the government may request unilaterally under the terms of the proposed settlement.
3. OhioHealth’s alleged market position – approximately 35% or more market share – was a central element of DOJ’s theory of harm. This case is a reminder that companies with significant market share in any industry should carefully evaluate their customer and supplier contracts to assess whether particular terms could be viewed as foreclosing the ability of competitors to enter or expand, whether through explicit contractual requirements or through practical effect.
4. Hospital systems and other healthcare providers may wish to use this development as an occasion to review their existing payor contracts with counsel. Healthcare pricing and access remain prominent public policy issues, and antitrust enforcement in the healthcare sector has been a stated priority across administrations.

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