A Settlement and a Signal: What the OhioHealth Deal Means for the Future of Hospital Contracting

On June 16, 2026, the U.S. Department of Justice Antitrust Division (DOJ), alongside the Ohio Attorney General (Ohio AG), filed a proposed consent judgment to resolve its civil enforcement antitrust lawsuit against OhioHealth Corporation (OhioHealth).  Without any admission of wrongdoing or payment of fines, OhioHealth agreed to the settlement, which voids existing contract provisions that restrict steering and price transparency, prohibits such terms in the future, prevents OhioHealth from penalizing insurers for offering innovative or lower-cost plan designs, and establishes a five-year independent monitorship to ensure compliance. 

Key Takeaways

• A developing enforcement framework.  The proposed judgment sets out in detail the types of contractual provisions that antitrust regulators are focused on in hospital–insurer contracts.  This approach allows DOJ and the Ohio AG to achieve their desired enforcement outcomes and to signal to the wider industry the terms that may draw unwanted scrutiny without the risk of an adverse court ruling on its legal theories, particularly with OhioHealth’s motion to dismiss pending.
• New red lines for hospital contracts.  The proposed judgment focuses on terms that allegedly penalize insurers for offering “Steered Plans,” broadly defined to include narrow networks, tiered networks, and reference-based pricing.  Exhibit A of the proposed judgment outlines contract language that is not permitted under the terms of the settlement, such as clauses that automatically trigger rate hikes or contract termination if an insurer’s decision to exclude a hospital from a network has an “adverse and material financial impact,” and also outlaws “gag clauses” that allegedly restrict price transparency.  
• Two paths for NYP.  This settlement provides a template for DOJ’s nearly identical lawsuit against New York-Presbyterian (NYP).  However, NYP is pushing back.  NYP argued in a recent court filing on May 26, 2026, that the challenged terms are industry-standard, demanded by insurers themselves, and in fact lower prices.  NYP has a choice: either follow OhioHealth’s lead and settle or force DOJ to prove its contested legal theory in court.
• Permitted conduct defines the boundaries.  While the settlement outlines problematic contract terms, it also explicitly identifies certain “permitted conduct,” providing a clearer safe harbor for hospital systems.  For example, systems may still negotiate for participation in a most-preferred tier “under the same terms and conditions as any other Provider,” and they may restrict steering within a narrow network where they are the most-prominently featured provider.  Finally, the agreement preserves a provider’s right to protect its negotiated rates from disclosure to competitors or the public (unless required by law) and to challenge inaccurate information.  These guardrails offer guidance for other hospital systems assessing their own antitrust risk. 

Background of the Case

The government’s lawsuit, filed on February 20, 2026, alleged that OhioHealth, a large healthcare system with approximately 35% market share of the relevant general acute care (GAC) inpatient hospital services in the Columbus area, used its market power to force anticompetitive terms into its contracts with commercial insurers.  The complaint focused on provisions, including anti-steering, anti-tiering, and “all-or-nothing” clauses, that allegedly prevented insurers from offering lower-cost health plans that would steer patients to OhioHealth’s rivals.  The government claimed these practices stifled competition and led to higher healthcare costs and reduced choice.  The case was seen as part of DOJ’s renewed focus on civil conduct antitrust enforcement, particularly in “pocketbook” industries like healthcare. 

Looking Ahead

The proposed settlement is subject to a 60-day public comment period under the Tunney Act, after which the court may enter the judgment upon finding it is in the public interest. 

More broadly, if the proposed consent judgment is entered, it is likely to have implications across the sector.  For other “must-have” hospital systems, it provides some contours to a still-evolving risk landscape, in which enforcers have articulated an approach for challenging certain contracting practices, even as the underlying legal questions remain contested.  Providers may therefore wish to review their commercial arrangements in light of this development, particularly as further cases may test the durability of the agencies’ approach. 

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