In re Mission Health Antitrust Litigation

Date Filed: June 3, 2022
Status: Pending
District Court: Western District of North Carolina – No. 1:22-cv-114
Nature of Suit: Anticompetitive Practice
Defendant Type: Provider
Plaintiff Type: State
Court Document:

Originally filed in federal district court by the city of Brevard, North Carolina (City of Brevard, North Carolina v. HCA Healthcare and Mission Health System), the lawsuit seeks class action status and alleges HCA used its monopoly power to demand anticompetitive terms that inflated prices in Asheville and seven surrounding counties in North Carolina.

The original complaints­–filed by City of Brevard and Buncombe County/City of Asheville–closely mirror each other and similarly allege antitrust violations under Sections 1 and 2 of the Sherman Antitrust Act. After Madison County’s Board of Commissioners voted to join the litigation in July, a motion to consolidate the two actions was granted in August, with the City of Brevard docket as the leading case. Proceeding under the new name In re Mission Health Antitrust Litigation in the Western District Court of North Carolina, the consolidated complaint on behalf of the two counties and two municipalities in the case was filed on August 19 and the defendants filed separate motions to dismiss on September 9.

These lawsuits allege that HCA’s acquisition of Mission Health in 2019 gave the combined entities increased market power and leverage with control of more than 85% of general acute care (GAC) market in the Asheville region, where Mission Health’s flagship hospital is located.  These cases also allege that market shares of HCA and Mission Health reach 86.6% in Buncombe County, 90% in Madison County, and over 70% in the surrounding counties. Consequently, plaintiffs allege that the combined market power of HCA with Mission Health, which had allegedly employed existing anticompetitive scheme since 1995 pursuant to a state-issued COPA, allowed the health systems to force insurers to enter contracts that include all-or-nothing, anti-tiering and anti-steering, and gag clauses. Furthermore, the complaints allege that HCA refused to comply with the new federal hospital transparency rule that requires disclosure of the prices it charges for GAC and outpatient services, which would reveal its prices to be the highest in North Carolina. The complaints request damages and injunctions against such anticompetitive practices.

Plaintiffs in the consolidated case:

  1. City of Brevard (filed 6/3/22)
  2. Buncombe County and City of Asheville (filed 7/27/22)
  3. Madison County (joined 7/25/22)

Associated Legislation:

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