On July 25, 2025, the Cement and Concrete Workers DC Benefit Fund, a self-funded union health plan, filed suit against The New York and Presbyterian Hospital, claiming that New York Presbyterian (NYP) engaged in various anti-steering efforts in violation of federal antitrust law that prevented the union from encouraging members to access more affordable care, costing the fund millions in allegedly overpriced care.

NYP is a healthcare system across the greater New York City metropolitan with more than 6,500 affiliated physicians, 20,000 employees and operates 4,000+ beds in total. Forbes lists NYP as having $13.3 billion in total revenue. According to the lawsuit filed by the Cement and Concrete Workers DC Benefit Fund, NYP’s market power results from “its large size, significant barriers to entry in the market, the comprehensive range of healthcare services it offers, … and insurers’ need to include access to NYP’s hospitals—as well as its other facilities and providers—in at least some of their provider networks in insurance plans that cover people who live and/or work in New York City.” Although NYP operates as a non-profit, the suit claims that the “CEO of NYP paid himself $63.7 million over the last five years of reporting, for an average of nearly $13 million per year…. NYP’s COO was the third highest-paid hospital executive in New York, with compensation totaling $7.3 million. Dozens of other executives at this ‘non-profit’ are paid over $1 million in compensation every year.”

Through plan design, health plans, like the Cement and Concrete Workers DC Benefit Fund, may “steer” patients toward higher-value care by directing them to providers that deliver comparable or better quality at lower cost. This steering can reduce unnecessary spending while maintaining or improving outcomes. The use of steering can significantly reduce costs for health plans and employers. The successful use of anti-steering methods by health systems prevents plans from encouraging members to seek more cost-effective care, and ultimately force these plans to pay more for healthcare than they otherwise would. The suit claims “NYP forces anti-steering restraints on all or nearly all Network Vendors and health plans”. The suit asks the court to determine that NYP’s actions in imposing anticompetitive contract terms on health plans to be a restraint of trade in violation of the Sherman Act.