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The allegations
On March 26 the Justice Department’s Antitrust Division and the U.S. Attorney’s Office for the Southern District of New York sued NewYork-Presbyterian in federal court, alleging violations of Section 1 of the Sherman Act. According to the government, the system’s contracts with payers bar plans that leave it out of the network, bar plans that do not place it in the most favored tier, and prohibit lower copays for patients who choose rival hospitals, which the department says are often less expensive. The government is asking the court to stop the system from imposing restrictions that keep insurers and employers from offering budget-conscious plans.
The probe followed a 2024 complaint from a building service workers union. NewYork-Presbyterian has called the suit without merit, says it complies with federal and state law, and argues that insurers hold the market power and use it to restrict patient choice.
A pattern, not a one-off
The case closely tracks the suit the department and Ohio Attorney General Dave Yost filed against OhioHealth on Feb. 20. There, the government alleged that the Columbus system generally required insurers to include it in every commercial network regardless of how its prices compared with competitors, blocking lower-cost plan designs. Together, the two cases describe a federal theory aimed at three kinds of contract language: all-or-nothing participation, guaranteed top-tier placement, and limits on financial incentives that steer patients elsewhere.
The timing also lines up with the Federal Trade Commission’s new healthcare task force, announced six days earlier. Hospitals should expect both agencies to compare notes.
What to do now
- Contract inventory: Have counsel review commercial payer agreements for clauses that require inclusion in all products, guarantee a preferred tier, or restrict benefit designs that favor competitors.
- Negotiation playbook: Retire tactics that rely on these provisions, and document the cost, quality or access reasons behind the terms you keep.
- Employer relationships: Prepare for large employers to request tiered or narrow products and decide how to compete for them on price and quality.
- Board briefing: Explain the exposure to the board and finance committee, including the revenue at stake if contested terms must be removed.
Archive entry for Mar 26, 2026, added Nov. 11, 2026.
Sources
- Justice Department sues New York-Presbyterian Hospital over anticompetitive contracts (U.S. Department of Justice, Mar 26, 2026)
- NewYork-Presbyterian named in antitrust lawsuit (Becker’s Hospital Review, Mar 26, 2026)
- Justice Department sues OhioHealth over anticompetitive healthcare contracts (U.S. Department of Justice, Feb 20, 2026)