OhioHealth on trial: feds say its contracts force Ohioans to overpay for care

Feds and Ohio target OhioHealth contracts

The Justice Department and Ohio Attorney General Dave Yost filed a civil antitrust lawsuit against OhioHealth Corporation on Feb. 20, 2026.

The complaint landed in the U.S. District Court for the Southern District of Ohio.

At the center of the case: contract terms, the government says force patients and employers to pay higher healthcare prices.

OhioHealth is the largest hospital system in central Ohio, with more than 24,000 employees and a physician network of 35,000.

OhioHealth runs a large Ohio footprint

OhioHealth owns or manages 16 hospitals and outpatient facilities across the state. Its reach covers 50 of Ohio’s 88 counties.

The system’s size puts it in a strong position when negotiating with insurance companies that want to sell health plans in central Ohio.

That size, the government argues, is exactly what made the alleged contract practices possible. The complaint says these restrictions have been in place since at least 2003.

Government says contracts locked out competition

The lawsuit alleges OhioHealth used its market power to force restrictive terms on commercial health insurers.

Specifically, the government says OhioHealth required insurers to include all of its providers in every commercial network, no matter how its prices compared to competitors.

This “all-or-nothing” approach left insurers with little room to push back.

The complaint also alleges OhioHealth used “gag rules” that blocked insurers from sharing truthful pricing information with patients in the Columbus area.

What “all-or-nothing” contracts actually do

In a normal market, insurers build networks by picking hospitals based on price and quality. “All-or-nothing” contracts take that option off the table.

An insurer that wants any OhioHealth provider must take all of them. That removes the incentive for the health system to compete on cost to earn a spot in a plan.

It also blocks insurers from building cheaper “narrow network” plans. Patients end up with fewer plan choices and less control over what they pay.

OhioHealth holds a big share of Columbus beds

OhioHealth controls more than 35% of inpatient general acute care hospital beds in the Columbus metropolitan area, according to the complaint.

That share is larger than any single competitor in the region.

OhioHealth’s main rivals in Columbus are the Ohio State University Wexner Medical Center and Mount Carmel Health System, owned by Trinity Health.

The complaint says the restrictions allegedly apply to insurers covering at least 85% of commercial insurance business in the Columbus area.

Lawsuit targets two federal and state laws

The complaint alleges violations of the federal Sherman Act and Ohio’s Valentine Act, both of which bar anticompetitive business practices.

The government asks the court to block OhioHealth from enforcing the disputed contract terms and to stop the system from replacing them with similar restrictions.

If the court sides with the government, insurers could build plans that steer patients toward lower-cost hospitals without being required to include every OhioHealth facility.

What a win could mean for Columbus patients

If the DOJ wins, Columbus-area insurers could design health plans that skip higher-priced OhioHealth facilities in favor of lower-cost options.

That could bring down premiums and out-of-pocket costs for patients and employers. Patients could also gain access to pricing details that make it easier to compare costs between hospitals.

Competing hospitals could attract more patients by offering lower prices or better quality. The DOJ says the current setup likely costs patients and employers more than they would pay in a competitive market.

OhioHealth says it will defend its position

OhioHealth initially said it had not been served with the complaint and that commenting on pending litigation would be inappropriate.

In a later statement, the health system said it cooperated as the DOJ reviewed its managed care agreements.

OhioHealth said it is confident in its position and remains committed to full compliance with all applicable laws.

The system declined to address the specifics of the active litigation.

DOJ calls healthcare affordability a top focus

Acting Assistant Attorney General Omeed Assefi said the DOJ’s mission centers on affordability and that the department wants to be as aggressive in enforcement as possible because of the direct returns to everyday people.

CBS News reported this is the first civil antitrust enforcement action by the Antitrust Division in about a year. The DOJ’s probe into OhioHealth had been underway for several years.

Officials also told CBS News this is one of several ongoing investigations into dominant healthcare systems across the country.

A California case offers a preview

The OhioHealth lawsuit mirrors past legal actions against large nonprofit hospital systems.

In California, Sutter Health paid $575 million in 2021 to settle allegations brought by the state attorney general over similar “all-or-nothing” contract practices.

Sutter also paid about $228.5 million in 2025 to settle a related class-action lawsuit filed by patients and businesses.

Both cases alleged Sutter used its market dominance to inflate healthcare costs across Northern California. Legal analysts say those outcomes could influence how courts view OhioHealth’s contracts.

Hospital contract cases carry national weight

Hospital consolidation and restrictive contracting are a concern across the country, not just in Ohio.

When a dominant hospital system can dictate terms to insurers, patients in that market often face higher costs and fewer plan choices.

Federal and state enforcers have increasingly gone after these practices in recent years. The OhioHealth case could set a precedent for how courts evaluate similar contracts at hospital systems elsewhere.

For Americans dealing with rising healthcare costs, the outcome could signal how far the government can go in challenging these arrangements.

Case is in early stages with no timeline set

OhioHealth has not yet formally responded to the complaint in court. The system could file a motion to dismiss or fight the allegations at trial.

No timeline has been set, and similar hospital antitrust cases have taken years to resolve. Sutter Health’s California cases took roughly seven and 13 years, respectively, before final settlements.

Columbus-area residents with commercial health insurance through an employer or individual plan could be affected by whatever the court decides.

This article was created with AI assistance and human editing.

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