State attorneys general are increasingly challenging federal antitrust settlements and merger approvals—most recently in the $6.2 billion Nexstar/Tegna broadcast television transaction. In addition, congressional Democrats have proposed expanding the Tunney Act to enhance transparency, empower states to continue abandoned federal cases, and constrain merger closings during judicial review. For companies planning strategic transactions, these developments signal that federal clearance alone may no longer end deal risk.
Healthcare Consolidation and Competition State Legislation Tracker: 2025 in Review
State legislatures are increasingly active in reshaping healthcare markets, with 2025 marking a particularly aggressive year for legislative action. Across many jurisdictions, new laws expand premerger visibility into healthcare deals, require greater ownership and affiliation transparency, restrict private equity and management service organization involvement in clinical enterprises, recalibrate certificate‑of‑need (CON) frameworks and curb post‑employment noncompete for physicians and other clinicians. Several measures also address patient‑facing transparency and communications. While federal scrutiny of healthcare transactions and practices remains significant, new state legislation is presenting most immediate changes to deal planning, governance and employment structures. Read the full Alert on the Duane Morris website.
Senate Democrats Introduce Sweeping Meatpacking Industry Legislation with Significant Antitrust Implications
On March 5, 2026, Senate Democrats introduced legislation that would fundamentally restructure the U.S. meatpacking industry. The Family Grocery and Farmer Relief Act proposes mandatory divestitures, cross-protein operation bans, foreign ownership restrictions and new limitations on vertical supply relationships—changes that could affect virtually every major player in the sector.
California’s AB 1776 Would Significantly Expand State Antitrust Law
The California Legislature is currently considering a bill that would substantially expand the scope and enforcement mechanisms of California’s antitrust regime. On January 30, 2026, the California Law Revision Commission officially approved a final legislative proposal to broaden the state’s antitrust statute, the Cartwright Act, to include single-firm conduct and to allow state enforcers to go beyond the federal Sherman Act. While the bill, AB 1776, remains under consideration in the state Legislature, it reflects a broader trend toward more aggressive antitrust regulation and enforcement at the state level, both in California and nationally. Read the Alert on the Duane Morris LLP website.
DOJ’s Antitrust Division and State of Ohio Sue Healthcare Provider OhioHealth Over Steering Provisions in Its Contracts with Health Insurers
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.
Read the Duane Morris Antitrust Class Action Review 2026
By Gerald L. Maatman, Jr., Jennifer A. Riley and Sean McConnell
Class action litigation involving antitrust claims had several key developments in 2025, despite a relative lack of actual verdicts. Because antitrust remedies often allow recovery of treble damages, the incentive to settle these cases is often paramount. Additionally, plaintiffs are entitled to reasonable attorneys’ fees that may be substantial because of the complexity of this kind of litigation. As a result, most antitrust class actions are settled before trial, and one of the most crucial phases in these cases is class certification. Thus, the order granting or denying a motion to certify a class in these cases is critical.
Click here to bookmark or download a copy of the Antitrust Class Action Review – 2026 e-book.
Major Multistate Cannabis Operators Face First-of-Their-Kind Antitrust Claims
By Sean P. McConnell, Wayne A. Mack, Christopher H. Casey, Paul P. Josephson, Tracy Gallegos, Michael D. Schwamm, and James Hearon
The Ohio attorney general recently filed an unprecedented state antitrust enforcement action against nine of the nation’s largest multistate cannabis operators. The complaint alleges these defendants formed illegal cartels through reciprocal supply agreements, competitively sensitive information exchanges and discriminatory distribution practices designed to exclude independent Ohio cannabis operators from the market and artificially inflate consumer prices. The complaint seeks injunctive relief, civil forfeitures of $500 per day per defendant for each day the alleged combinations were in effect, and attorneys’ fees.
Read the full Alert on the Duane Morris LLP website
FTC Announces Increased Reporting Thresholds for 2026 Under the Hart-Scott-Rodino Antitrust Improvements Act
On January 14, 2026, the Federal Trade Commission announced increases to the jurisdictional thresholds for premerger notification under the Hart-Scott-Rodino Antitrust Improvements Act. The FTC adjusts the thresholds annually, consistent with changes to gross national product. The announced changes will become effective for filings made or transactions closing 30 days after publication of the revised thresholds in the Federal Register.
NASCAR & Racing Teams Settle Antitrust Dispute
On December 11, 2025, NASCAR settled an ongoing and closely watched antitrust trial brought by two racing teams, 23XI Racing (co-owned by Michael Jordan) and Front Row Motorsports, in the U.S. District Court for the Western District of North Carolina. The settlement was announced after the plaintiffs had presented their case-in-chief and following testimony from several high-profile witnesses, including Jordan. The financial terms of the settlement have not been publicly disclosed, but the agreement aims to provide a more equitable business framework for teams in the sport.
State AGs Move to Intervene in Federal Oversight of DOJ’s $14 Billion Merger Agreement
On October 14, 2025, a coalition of 13 state attorneys general, including those from California, New York, Massachusetts and Illinois, filed a motion seeking to intervene in the Tunney Act review by the United States District Court for the Northern District of California of the U.S. Department of Justice’s (DOJ) settlement that allowed the $14 billion merger between Hewlett Packard Enterprise (HPE) and Juniper Networks to proceed.
Read the full Alert on the Duane Morris website.