Key Takeaways

• The US Department of Justice and Ohio Attorney General challenged OhioHealth's managed care contracting practices, alleging certain contract provisions limit insurers' ability to create lower-cost, value-focused provider networks and benefit designs.
• Regulators argued that anti-steering, all-or-nothing contracting, and transparency restrictions reduced competition among providers and limited consumers' access to lower-cost care options.
• A proposed settlement would prohibit OhioHealth from using specific contract provisions going forward, signaling continued antitrust scrutiny of provider-payer agreements that may affect network design, health care costs, and patient choice.

The DOJ's Antitrust Division and the Ohio Attorney General sued OhioHealth Corporation, alleging that the health system used its market position in central Ohio to impose contract terms that restricted competition among providers and health plans.^1,2 Regulators contend that these provisions prevented commercial insurers from offering innovative, lower-cost insurance products and reduced consumers' ability to access information about lower-cost care options.₁

According to the complaint, OhioHealth required insurers to include OhioHealth facilities across all commercial insurance networks if they wished to contract with any OhioHealth provider. The government alleges these requirements limited insurers' ability to develop narrower or value-focused networks that could steer members toward lower-cost providers.¹

The lawsuit was filed in the US District Court for the Southern District of Ohio and alleges violations of both the federal Sherman Act and Ohio's Valentine Act.^1,2

Why Regulators Filed the Case

Federal and state regulators argue that OhioHealth's contracting practices insulated the health system from competition on price and quality.¹

The complaint focuses on several categories of contract provisions:

Anti-Steering Restrictions

The government alleges that OhioHealth restricted insurers from encouraging members to use lower-cost providers through benefit design, incentives, or network structures. Regulators argue these provisions limit payers' ability to create products that reward members for selecting more affordable care options.¹

All-or-Nothing Contracting

According to the complaint, insurers seeking access to OhioHealth providers were generally required to include the health system throughout their commercial product portfolios. Regulators contend this prevented plans from selectively contracting with providers based on cost, quality, or value.¹

Restrictions on Transparency

The lawsuit also challenges provisions that allegedly limit insurers' ability to share information about lower-cost alternatives with members. Regulators argue these restrictions reduced consumers' access to price and quality information that could support informed health care decisions.¹

What OhioHealth Said

OhioHealth stated that it cooperated with the DOJ during its review of managed care agreements and maintained confidence in its legal position. The health system said it remains committed to compliance with applicable laws and regulatory requirements and declined to comment further because of ongoing litigation.^3,4

Following the June 2026 settlement announcement, OhioHealth agreed to a proposed settlement that would prohibit certain contracting practices identified in the complaint. The proposed final judgment contains no monetary penalties or damages and does not constitute an admission of liability.^3,4

Why It Matters for Payers

The OhioHealth case centers on issues that have become increasingly important for health plans, employers, and managed care organizations seeking to manage health care costs.

If regulators prevail—or if the proposed settlement is approved—the case could reinforce insurers' ability to do the following:

• Develop narrow-network and tiered-network products.
• Design benefit structures that steer members toward lower-cost providers.
• Provide greater price and quality transparency to members.
• Negotiate network arrangements that emphasize value-based competition among providers.^1,3

The litigation also signals continued regulatory attention to hospital contracting provisions that may affect payer flexibility in network design and product development. For managed care organizations, the case serves as another example of how provider-payer contracting strategies may face antitrust scrutiny when regulators believe they limit competition or raise costs for employers and consumers.¹

What Comes Next?

In June 2026, the DOJ and Ohio Attorney General announced a proposed settlement that would prohibit OhioHealth from enforcing or seeking certain contract provisions that restrict steering, limit transparency, or discourage innovative plan designs.³ If approved by the court, the settlement would void existing challenged provisions and prevent similar restrictions in future contracts.^3,4

For payers and managed care stakeholders, the outcome may provide additional guidance on how regulators view provider contracting practices that affect network design, consumer choice, and health care affordability.^3,4

References

1. United States of America and State of Ohio v OhioHealth Corporation. Complaint. US District Court for the Southern District of Ohio. Filed February 2026. Accessed June 19, 2026. https://www.justice.gov/atr/media/1428276/dl
2. Yost D. Attorney General Yost joins Department of Justice to sue OhioHealth for anticompetitive health care contracts. Ohio Attorney General. News release. February 2026. Accessed June 19, 2026. https://www.ohioattorneygeneral.gov/Media/News-Releases/February-2026/G-Yost-Joins-Department-of-Justice-to-Sue-OhioHeal
3. US Department of Justice. Justice Department requires OhioHealth to stop using anticompetitive healthcare contracts that increase costs for Ohioans. News release. June 18, 2026. Accessed June 19, 2026. https://www.justice.gov/opa/pr/justice-department-requires-ohiohealth-stop-using-anticompetitive-
4. United States of America and State of Ohio v OhioHealth Corporation. Proposed Final Judgment. US District Court for the Southern District of Ohio. Filed June 2026. Accessed June 19, 2026. https://www.justice.gov/atr/media/1446356/dl