COLUMBUS, Ohio—(AVC News)—-A union health and welfare benefit fund last week filed a class action antitrust lawsuit against Columbus-based OhioHealth.
According to a report published by Becker’s Hospital Review, the suit is alleging that the system’s contracts with insurers blocked lower-cost plan designs and inflated what payers paid for care,
Cleveland Bakers and Teamsters Health and Welfare Fund filed the complaint in the U.S. District Court for the Southern District of Ohio on August 19. The self-funded union health plan covers about 10,000 people and said it paid about $1.2 million to OhioHealth over the past four years at prices it alleges were inflated.
The suit alleges OhioHealth used its position in Central Ohio to impose contract terms that blocked or penalized steering, tiering and narrow networks, and required network vendors to include all OhioHealth facilities and providers if they wanted to include any of them.
Further, the complaint alleges that the contract provisions limited insurers’ ability to steer patients toward lower-cost providers and prevented employers and health plans from designing narrower or tiered networks that could exclude higher-cost OhioHealth facilities. The complaint alleges those restrictions reduced competition and resulted in higher healthcare costs for health plans and their members.
The complaint brings claims under the Sherman Act, Ohio’s Valentine Act and unjust enrichment under Ohio common law, and seeks treble damages and an injunction.
According to the Becker’s report, OhioHealth commented only by saying; “We are confident in our position and dispute the allegations in this lawsuit.”
The system declined to comment beyond this statement.
Back in June of this year, OhioHealth reached a settlement with state and federal regulators, halting the healthcare system from enforcing contract terms that limit how insurers can help patients find lower-cost care.
The settlement allowed OhioHealth to not admit to any wrongdoing, nor pay any fines.
