On February 20, 2026, the US Department of Justice Antitrust Division (DOJ) and the Ohio Attorney General (Ohio AG) brought a civil action against OhioHealth Corporation (OhioHealth) in the US District Court for the Southern District of Ohio alleging that OhioHealth violated federal and state antitrust laws through restrictive contracts and anti-steering practices. DOJ and the Ohio AG allege that OhioHealth’s actions have stifled competition and artificially inflated healthcare costs in Columbus, Ohio.
Key Takeaways
- Renewed emphasis on civil enforcement. This lawsuit marks DOJ’s first civil enforcement action in slightly over a year and follows recent statements from Acting Assistant Attorney General (AAG) Omeed Assefi emphasizing the need for increased civil enforcement.
- Continued focus on “pocketbook” issues. This action against OhioHealth aligns with the Trump administration’s “America First Antitrust” guidance, which prioritizes industries where competition directly affects everyday household costs. Antitrust enforcers have cited healthcare as a prime target for this policy, and this lawsuit continues that trend of increased scrutiny in the healthcare sector.
- The continued rise of state AG enforcement. The joint lawsuit between DOJ and the Ohio AG underscores the growing role of state attorneys general in policing competition, and we expect this trend to continue.
Background of the Case
According to the complaint, OhioHealth has market power in the provision of inpatient general acute care hospital services in the local Columbus market, and it used its position to restrict the ability of commercial insurers (payors) to design and offer lower-cost health plans. The complaint alleges that OhioHealth restricted competition with its rival hospitals through a variety of contractual provisions with payors, including anti-steering provisions, limitations on price transparency, and requirements to include all OhioHealth hospitals in an insurance plan and provide them with the highest benefit tier. In addition to its size, OhioHealth’s network contains rural hospitals that the complaint alleges insurers must include in their networks to maintain coverage, which limits payors’ ability to effectively negotiate with OhioHealth. This tactic allegedly prevents payors from offering more cost-effective insurance plans that feature OhioHealth’s lower-priced rivals.
As a result of OhioHealth’s contract provisions and practices, DOJ and the Ohio AG argue that these restrictions prevent lower-cost healthcare providers from gaining patient volume and achieving the scale required to compete effectively. Both antitrust enforcers allege that OhioHealth’s conduct increases healthcare costs and reduces choices for patients and employers in Columbus, Ohio.
Looking Ahead
Only time will tell whether the court will agree with DOJ and the Ohio AG’s allegations of OhioHealth’s market power and effect on competition through its contracts and practices. Payors and hospital systems alike should be on notice that both federal and state antitrust enforcers are heavily scrutinizing contracts and other restrictions in keeping with the Trump Administration’s stated focus on rising healthcare costs.
