On February 20, 2026, the United States Department of Justice and the State of Ohio sued OhioHealth Corporation, a non-profit that operates healthcare facilities and physician groups throughout Ohio, in the U.S. District Court for the Southern District of Ohio. The complaint alleges that OhioHealth has market power in the Columbus, Ohio area, where it operates its flagship Riverside Methodist Hospital and other facilities. The plaintiffs assert that OhioHealth has shored up its market power through anticompetitive conduct, in violation of Section 1 of the Sherman Act and Ohio’s Valentine Act.
DOJ and the State of Ohio allege that OhioHealth’s agreements with insurers limit insurers’ ability to offer different types of “steered plans,” or steering provisions, including 1) “tiered plans,” which charge insurance subscribers less when they opt to use a more limited panel of cost-effective providers for a particular service, 2) “center of excellence plans,” which similarly charge patients less when they choose to obtain care from a center of excellence provider for a particular service, 3) “narrow network plans,” which include fewer providers and typically have lower premiums for employers and subscribers, 4) plans that include “site of service steering,” which lower costs for subscribers when they seek care from less expensive facilities (e.g., from an ambulatory center rather than a hospital), 5) plans with “reference-based pricing,” which offers subscribers a set reimbursement based on a calculation of the market average, and 6) plans with “active transparency,” in which insurers contact patients to inform them of less costly options prior to a particular procedure or appointment.
The complaint further alleges that OhioHealth collects higher reimbursement rates from insurers than surrounding hospitals, despite offering similar or lower quality care, and that its conduct allegedly allows it to continue collecting supracompetitive reimbursement rates by dampening competition between healthcare providers. Plaintiffs also allege that OhioHealth’s agreements with insurers harm consumers by reducing competition between hospitals to attract patients and eliminating product choices that are available to patients in other parts of the country and would otherwise exist in the Columbus area.
The DOJ and State of Ohio allege that the product market is the sale of inpatient general acute care hospital services to commercial payors and the geographic markets include 1) the area comprising Delaware and Franklin Counties and 2) the Columbus Metropolitan Statistical Area.
Stay tuned for updates on how the parties and court approach steering provisions in this market in the wake of Ohio v. American Express.
