In a prior Friction Point post, OhioHealth Sued by DOJ and State of Ohio for Market Power and Contracting Practices (Feb. 26, 2026), we discussed the complaint filed by the U.S. Department of Justice (DOJ) and the State of Ohio Attorney General against OhioHealth, alleging that OhioHealth’s managed care contracting practices violated federal and state antitrust laws. Rather than answer the complaint, OhioHealth filed a Motion to Dismiss for failure to state a claim upon which relief may be granted (i.e., under Civil Procedure rule 12(b)(6)) on May 8, 2026. The government plaintiffs filed a response to the Motion on May 29. Prior to OhioHealth filing a reply, on June 16, 2026, the parties entered a “Proposed Final Judgment” to settle the matter, subject to certain ongoing, post-judgment commitments and monitoring.
In sum, the resolution required the following of OhioHealth:
- Voiding and Ceasing Use of Certain “Steering” Contract Provisions – more about this below.
- Notifications to Payors – OhioHealth had to immediately notify all of its current payors about the agreed-upon judgement in the case, and it must continue to do so for as long as the judgment is in effect (see below).
- Ongoing Reporting and Monitoring – for five (5) years – i.e., how long the judgment is in effect – OhioHealth must provide quarterly written reports to the government plaintiffs and the “monitor” identifying payors with which it has contracted and whether it has engaged in any of the conduct prohibited by the judgment. The court is appointing an individual to serve as its monitor, taking proposals from the parties, who will be charged with monitoring compliance with the terms of the judgment. OhioHealth must enter into a written agreement with, and bear the cost of, the appointed monitor. The monitor must make written reports to the government defendants at a frequency to be established but no less than every 180 days during the first two years. An initial and annual report to the court is also required of the monitor.
The consent judgment attached three examples of contract language that OhioHealth agreed is now void and will not be used:
- Network exclusion or adverse impact penalties – this example provided that OhioHealth could require a payor to adjust its payment for covered services to offset the “adverse and material financial impact” caused by excluding OhioHealth or by including OhioHealth at low reimbursement rates.
- “Limited benefit plan” penalties – this example provided that an exclusion of OhioHealth as a network provider, or an inclusion of OhioHealth as a network provider in a plan that capped the annual benefit (i.e., a limited benefit plan) provided OhioHealth with a right to terminate the contract with the payor on 90 days notice unless OhioHealth consented to the exclusion or inclusion and the payor would have to make a payment adjustment to offset the “adverse and material financial impact” on OhioHealth.
- Use of OhioHealth Rates and Charges Information with Beneficiaries – this example prohibited payors from providing their beneficiaries with information about OhioHealth’s “higher payment rates and/or charges of Covered Services” at OhioHealth facilities versus other provider facilities, or any other activity to steer beneficiaries to other provider facilities based on price/charge differences.
The above examples do not represent the full scope of the consent judgment’s requirements, as defined terms such as “steering,” “transparency,” and “penalize” are used to encompass conduct illustrated by the examples.
From an impact perspective, this is likely a victory for OhioHealth assuming these are contract provisions it can live without. They do not impact or limit rate negotiations or other contracting rights that it can privately negotiate with payors. Presumably, there will be some impact on a copycat case filed by the DOJ in New York federal court against The New York and Presbyterian Hospital in March 2026 (reported in a prior blog post at Copy and Paste – New York & Presbyterian Complaint follows OhioHealth Template), but that case is still very early in its docket. The bigger impact may extend beyond OhioHealth, as the hospital industry is on edge about DOJ interest in hospital-payor contracting practices.
