On February 20, 2026, the Department of Justice (DOJ) and the Ohio Attorney General’s office filed suit against OhioHealth, a 16-hospital nonprofit health system, claiming that OhioHealth’s use of all-or-nothing terms (requiring insurers to include all of its providers in their networks) inflates costs for policyholders and disadvantages competitors.  The suit also claimed that OhioHealth’s contracts included terms requiring OhioHealth to be at the most-favored level of benefits in each network, and that payors were prevented from providing patients with price information about healthcare services.  The Source published an analysis of this case in March. […]

Antitrust and Market Competition Playing Favorites — State Protection of Academic Medical Centers from Antitrust Oversight New England Journal of Medicine Jaime S. King, Katherine L. Gudiksen, Anna D. Sinaiko The authors explore a new trend with U.S. academic medical centers (AMCs) merging with nonacademic hospitals and health care systems.  These mergers pose risks of price increases and other competitive harms.  Regulators should review all transactions involving an AMC and ensure that any promised benefits from consolidation do not harm the public.  Notably, at least four states have laws explicitly […]

On March 26, 2026, the Department of Justice (DOJ) sued New York-Presbyterian Hospital (NYP), claiming NYP used illegal anticompetitive terms in their contracts with payors.  In the related press release, the DOJ stated that “New York-Presbyterian uses its market power to protect its margins, impede competition from rival hospitals, and prevent employers and unions from creating [budget-conscious health plans].”  According to the complaint, NYP imposes restrictions in its contracts that prevent payors from offering plans that do not place NYP in the plan’s most-favored tier.  Additionally, payors are required to […]

Antitrust scrutiny of anticompetitive healthcare contract terms is on the rise, and the use of anticompetitive contract terms are increasingly in the crosshairs of both regulators and courts. When healthcare systems acquire a dominant market share, one method of capitalizing on this dominance is to impose anticompetitive terms on entities they contract with for financial gain and to forestall competition.  The use of anti-steering, anti-tiering, all-or-nothing, gag clauses, etc., can result in higher costs and reduced options for healthcare consumers.  In recent years, Indiana, Connecticut, Nevada, and Texas have enacted […]

The California State Legislature kicked off the first year of its 2025-2026 biennial Legislative Session on December 2, 2024. This year, the legislature got off to a sprinting start as it raced to meet the February 21, 2025 deadline to introduce new bills. Compared to last year, this year’s legislature proposed a wider swath of bills aimed at healthcare-related concerns, including enhanced merger review, the use of artificial intelligence (AI) in healthcare, and expanding access to both provider and coverage options for consumers. In this month’s California Legislative Beat, we […]

On Tuesday, June 4, 2024, the 9th U.S. Circuit Court of Appeals overturned Sutter Health’s win in a $411 million antitrust suit, saying that the jury that found in favor of Sutter in 2022 was given improper jury instructions, and that the plaintiffs were improperly prevented from presenting relevant evidence. In September 2012, a class of individuals and employers who purchased fully insured plans from the five largest commercial health insurance companies in California filed this lawsuit alleging that Sutter Health restricted competition in the healthcare market using anticompetitive tactics. A similar lawsuit, […]

See case page: Sidibe v. Sutter Health   On August 24, the 9th Circuit Court of Appeals heard oral arguments in the appeal of the federal class action Sidibe v. Sutter Health. A jury verdict in March 2022 in the Northern District Court of California had cleared the hospital giant of anticompetitive allegations that were initially filed over a decade ago. The alleged practices were also at issue in the case filed in state court by a labor union that was later joined by the attorney general, UEBT v. Sutter Health. […]

In the 2023-2024 legislative term, the California legislature has introduced a multitude of legislation targeting consolidation and competition in health care, system reform and price and quality transparency. In a two-part series, we highlight some of the noteworthy legislation proposed this session. Part 1 focuses specifically on the State’s efforts to promote a more competitive healthcare market by targeting restraints of trade and consolidation. In Part 2, the focus will shift to proposed bills targeting system reform, price and quality transparency, and prescription drug prices.   Health Care Consolidation California […]

In a New England Journal of Medicine article and accompanying interview, The Source Founder and Distinguished Fellow Jaime S. King provides an overview of the history of healthcare antitrust law and enforcement and discusses the functions of antitrust law and the effects of health care consolidation on prices, quality of care, and access to care. The perspective piece asserts that combining competitive and regulatory forces may offer the only hope for controlling health care prices, restoring high-quality care, protecting health care workers, and preserving and expanding access to care. Check out […]

Anticompetitive contracting practices have been under antitrust enforcement scrutiny from both state regulators and private parties in recent years. In California, hospital giant Sutter Health faced several high-profile lawsuits for its alleged anticompetitive contracts. While the state case led by the California attorney general settled earlier this year, the federal class action is on its way to the 9th Circuit appeal. HCA Healthcare, a large health system in North Carolina, appear to be the next health system under litigation fire for similar practices. Three separate actions have been filed by […]