On May 18, 2023, Strategic Organizing Center (SOC)—which is a coalition of labor unions Service Employees International Union (SEIU), Communications Workers of America, and United Farmworkers of America—as well as SEIU Healthcare Pennsylvania filed a complaint against University of Pittsburgh Medical Center (UPMC) with the Department of Justice (DOJ). UPMC is a nonprofit cross-market system that operates as health care provider and insurer with forty hospitals in Pennsylvania, New York, and Maryland.  

The complaint urges the DOJ to investigate whether UPMC has violated Section 2 of the Sherman Act, which prohibits monopolies and attempts to monopolize. The unions allege that UPMC’s monopsony power has enabled them to engage in anticompetitive pay practices, such as as noncompete clauses, do-not-rehire blacklists, and suppressing collective-bargaining efforts, while maintaining sub-competitive working conditions. The complaint also alleges that UPMC has monopoly levels of market share in multiple markets, and that it uses its market power to harm rival medical providers and health plans. Furthermore, the unions suspect that UPMC’s conduct has eroded the quality of patient care.