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DOJ and Ohio settle antitrust case with OhioHealth over anti-steering, anti-tiering contracts

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Why it matters

The Department of Justice and Ohio Attorney General have reached a proposed settlement with OhioHealth Corporation, a 16-hospital nonprofit system based in Columbus, resolving civil antitrust allegations over anti-competitive contracting practices with commercial insurers. The consent judgment voids existing contract terms that prohibit patient steering, restrict steered plans, or limit price transparency. OhioHealth is barred from seeking such provisions in future agreements. The settlement requires no admission of wrongdoing, imposes no fines or damages, but mandates a five-year monitoring period with quarterly compliance reports.

The DOJ filed the case on February 20, 2026, alleging OhioHealth used its market dominance—controlling over 35 percent of inpatient services in greater Columbus—to inflate reimbursement rates through all-or-nothing tying clauses, anti-steering provisions, and gag clauses preventing insurers from sharing cost and quality data with patients. The settlement specifically prohibits OhioHealth from requiring insurers to place it in their most-preferred benefit tier, though the system may still seek such placement voluntarily. The case names the DOJ Antitrust Division and Ohio Attorney General's Office as plaintiffs.

The enforcement action reflects a coordinated Trump administration push against dominant hospital systems. Two days after the settlement filing, the White House Council of Economic Advisors released a report advocating a nationwide ban on anti-steering, anti-tiering, and all-or-nothing contracts, estimating such restrictions could reduce hospital prices by 18 percent and employer health premiums by 6.5 percent in affected markets. A nearly identical suit against NewYork-Presbyterian filed weeks earlier signals this is part of a broader enforcement trend.

Attorneys should treat this settlement as a compliance roadmap. Acting Attorney General Todd Blanche emphasized the case as a tool to lower consumer costs, and the coordinated timing with the White House report underscores federal commitment to reforming hospital-insurer contracting. Health systems and insurers nationwide should expect heightened scrutiny of network design restrictions and steerage limitations.

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