DOJ, Ohio AG and OhioHealth Settle Antitrust Case Over Anticompetitive Contracting

Continuing a trend by the U.S. Department of Justice, Antitrust Division (DOJ), to settle and not litigate antitrust enforcement actions, DOJ and the Ohio Attorney General announced a proposed settlement on June 16, 2026, resolving their antitrust lawsuit against OhioHealth Corporation, one of Ohio’s largest health systems. The settlement resolves the February 2026 complaint alleging that OhioHealth used contractual restrictions in its agreements with commercial health insurers to limit competition and increase health care costs in the Columbus, Ohio area in violation of Section 1 of the Sherman Act and the Ohio Valentine Act.

DOJ and the AG alleged that OhioHealth leveraged its market power to require insurers to agree to use all of OhioHealth providers across all plan networks and restricted insurers’ ability to offer lower-cost insurance products, which would include narrow-network and tiered-network plans to decrease health care costs.

Before the settlement, OhioHealth moved to dismiss the case, arguing that the challenged provider-payor agreements are vertical contracts entitled to substantial deference under antitrust law and that restrictions relating to plan design and steering are not inherently anticompetitive. OhioHealth also contended that the antitrust enforcers failed to plead anticompetitive effects, disputed the allegations regarding market power and argued that the lawsuit improperly sought to compel OhioHealth to assist its competitors.

Key Terms of the Proposed Settlement

Under the proposed settlement, OhioHealth is prohibited from imposing contractual provisions that discourage lower-cost insurance products or otherwise restrict insurers’ ability to compete through plan design. The consent decree voids existing provisions that restrict budget-conscious health plans, prohibits OhioHealth from seeking similar restrictions in the future and prevents the health system from penalizing insurers that encourage patients to use lower-cost providers. The consent decree preserves insurers’ ability to provide price and quality information to patients and subjects OhioHealth to oversight through a five-year compliance monitor and periodic reporting obligations to the Antitrust Division.

The settlement does not require OhioHealth to pay damages, civil penalties or fines. OhioHealth publicly that it continues to believe its contracting practices were lawful and appropriate and did not admit wrongdoing. OhioHealth maintains that the challenged provisions were originally adopted to address insurer practices that were common when the agreements were negotiated.

Key Takeaways for Health Care Providers

Although the proposed settlement remains subject to court approval following the Tunney Act public comment process, it is another indication of the Antitrust Division’s continued focus on health care contracting practices that allegedly impede competition and increase costs. The decree targets restrictions on steering, narrow- and tiered-network products and promotes insurer transparency initiatives, all reflecting the DOJ’s view that such provisions raise antitrust concerns when employed by providers with market power.

The settlement also reinforces that provider-payor contracting remains an active area of enforcement, even outside the merger context. Building on previously settled cases in North Carolina and Northern California involving hospital contracting practices, as well as the DOJ’s pending against New York Presbyterian Hospital, the OhioHealth settlement demonstrates that federal and state antitrust enforcers will continue to scrutinize hospital contracting terms that limit payor flexibility and are perceived to increase health care costs. Health care systems should review all of their payor contracts for all-or-nothing, anti-steering, or anti-tiering provisions, given the current enforcement environment.  

U.S. Dep’t of Just., Justice Department Requires OhioHealth to Stop Using Anticompetitive Healthcare Contract Terms That Raise Costs for Ohio Patients (June 16, 2026), .

U.S. Dep’t of Just., Justice Department Sues OhioHealth for Anticompetitive Healthcare Contracts That Increase Costs for Ohio Patients (Feb. 20, 2026), .

Mot. to Dismiss, United States & State of Ohio v. OhioHealth Corp., No. 2:26-cv-00207, ECF No. 18 (S.D. Ohio Feb. 20, 2026).