Brought by Uriel Pharmacy, a self-insured employer, the federal lawsuit alleges Advocate forced insurers to enter all-or-nothing and anti-tiering and anti-steering contract terms. In addition, the plaintiffs claim Advocate Aurora uses “a combination of acquisitions, referral restraints, noncompetes and gag clauses to suppress competition from other healthcare providers” and expand its monopoly power. With its must-have hospitals, the health system was able to demand higher prices for its services compared to other providers. The complaint cites the example of the price of joint replacement surgery, which costs $62,538 at Advocate Aurora hospitals, $21,000 higher than the price at a competitor hospital just five minutes away. This case followed the merger of Advocate Health Care and Aurora Health Care in 2018 that created Advocate Aurora, which allegedly gave rise to its substantial market power to demand anticompetitive terms.

After Uriel Pharmacy filed an amended complaint, Advocate Aurora moved to have the case dismissed. However, the court denied the motion to dismiss on April 28, 2023, and shortly thereafter, Advocate Aurora filed an answer to the amended complaint.