DOJ shifts antitrust focus

The Department of Justice is shifting its hospital antitrust work from mergers to contracts, suing health systems over insurer deals it says keep prices high. (justice.gov) The agency filed one case against OhioHealth on February 20, 2026, and another against NewYork-Presbyterian on March 26, 2026. In both suits, the Justice Department said the systems used contract terms that blocked lower-cost insurance options. (justice.gov) OhioHealth owns or manages 16 hospitals and outpatient facilities in Ohio, and the Justice Department called it the largest health system in central Ohio. NewYork-Presbyterian operates eight hospitals and many outpatient sites, and the department called it the largest and most powerful hospital system in New York City. (justice.gov) The contract fight is about how insurers build networks, the list of doctors and hospitals a plan will cover. The Justice Department says some systems used “all-or-nothing” terms that forced insurers to include every facility in a system instead of choosing cheaper sites one by one. (medcitynews.com) That approach differs from the merger cases that dominated hospital antitrust for years. Kaiser Family Foundation said federal and state enforcers have traditionally focused on mergers and acquisitions, but antitrust law also reaches nonmerger conduct that can raise prices without improving quality. (kff.org) In the OhioHealth case, the Justice Department said insurers were generally forced to include OhioHealth in all of their commercial networks, no matter how OhioHealth’s prices compared with rivals. The department said that prevented “budget-conscious” plans from emerging in the Columbus market. (justice.gov) In the NewYork-Presbyterian case, the Justice Department said similar restrictions kept insurers, employers and unions from offering lower-cost plans in New York City. Health Affairs wrote that the case centers on contract terms that can stop payers from steering patients toward lower-cost providers. (justice.gov) (healthaffairs.org) The health systems dispute the government’s view. MedCity News reported that OhioHealth and NewYork-Presbyterian said their managed-care contracts are lawful and help preserve broad access to care, even as both systems cooperated with reviews of those agreements. (medcitynews.com) The pressure did not start with the March federal complaint in New York. Health Affairs said labor unions filed two lawsuits in 2025 alleging similar conduct by NewYork-Presbyterian, and a third union asked the Justice Department to investigate the system’s contracting practices. (healthaffairs.org) For hospital executives and vendors, the practical shift is that sales claims about “network leverage” now land in a more sensitive legal environment. The safer pitch is becoming measurable operating results, because the Justice Department is now testing whether contracting behavior itself violates the Sherman Act. (medcitynews.com)