On June 18, 2026, the White House Council of Economic Advisors published a report (“CEA Report”) outlining the impacts of a nationwide ban on anti-steering, anti-tiering, and all-or-nothing contracting provisions in payor-provider contracts.[1] The CEA Report was issued just two days after the Department of Justice filed a proposed settlement with OhioHealth, which voided similar contract terms in OhioHealth’s payor contracts and prohibited the system from seeking such provisions in the future. The settlement and the CEA Report highlight this Administration’s continued focus on addressing competitive issues in the healthcare industry and scrutinizing provider contracting practices.
United States v. OhioHealth Corp.
The DOJ filed its complaint against OhioHealth in February 2026, alleging that the system—which owns and manages 16 hospitals as well as outpatient facilities and physician groups—leveraged its alleged market power in the greater Columbus area to (1) force commercial payors to contract on an all-or-nothing basis, and (2) extract alleged anticompetitive contractual terms from payors. Specifically, the DOJ alleged that OhioHealth’s contracts required OhioHealth be included in every network at the most favored benefit level, barred payors from financially incentivizing their members to use lower-cost providers, and prevented payors from informing members of price differences between OhioHealth and other providers. The DOJ argued these contracting practices effectively barred payors from:
- Offering certain health plans designed to reduce costs, such as narrow networks, tiered networks, centers of excellence, site-of-service steering, and reference-based pricing, including by requiring payors to include OhioHealth in essentially all offered networks at the most favored benefit level; and
- Providing truthful cost information and steering guidance to members.[2]
The DOJ claimed that these contracting practices violated Section 1 of the Sherman Act and Ohio’s state antitrust statute because they reduced plan choices and increased patients’ premiums and out-of-pocket costs.
As OhioHealth’s motion to dismiss was pending, the parties notified the court they had settled and filed a proposed judgment. Under the proposed judgment, OhioHealth must cease using contract terms that prohibit, deter, prevent, or penalize steering, steered plans, or pricing transparency.[3] The proposed judgment also prohibits OhioHealth from seeking any such terms in the future, as well as any contract provisions that require OhioHealth always be placed in the most-preferred tier of benefit designs (though it may still seek placement in that tier). To ensure compliance, OhioHealth is required to (1) provide notice of the proposed judgment to contracting payors, (2) engage a monitor chosen by the DOJ to oversee OhioHealth’s compliance with the proposed judgment, and (3) provide quarterly reports to the monitor for five years.
Although the DOJ’s competitive impact statement explaining the proposed settlement and following notice and comment period is still forthcoming, the DOJ emphasized the speed of the settlement, reposting an article on X that touted the “Swift Win” as a “pivotal moment for regulatory enforcement in the U.S. healthcare sector” and a lesson for hospitals nationwide.[4] The speed and willingness to settle the case reflects this Administration’s broader strategy to quickly enter into settlements that it believes resolve antitrust concerns.
The CEA Report[5]
The CEA Report is the second research report published by the White House Council of Economic Advisers in as many months regarding healthcare pricing.[6] The report, which analyzes the impact of contracting practices like those allegedly used by OhioHealth, concludes that prohibiting all-or-nothing, anti-steering, and anti-tiering contracting would save significantly on healthcare costs, allegedly reducing “hospital and affiliated-physician prices by 18 percent (with a plausible range of 11 to 26 percent), averaging ~$4,100 per inpatient admission . . . .” Similarly, the report estimates that employer-sponsored health premiums could likewise fall by roughly 6.5% in markets directly affected by such contracting provisions, which could yield national savings of roughly $45 billion per year. The report suggests that these cost savings will be achieved, for example, by restoring payors’ bargaining leverage and allowing payors to direct patients to lower-cost providers.
Certain states already have prohibited or restricted use of such contracting provisions,[7] and the CEA Report may spur further legislative or executive actions restricting such clauses at the state or federal level.
Takeaways
These two recent developments underscore, as Acting Attorney General Todd Blanche put it, “this administration[’s] . . . laser focus[] on affordability and cutting costs for the American people” by “bringing down healthcare costs for consumers and fighting the anti-competitive behavior that drove them up there in the first place.”[8] And the close timing of the CEA Report and OhioHealth settlement reveals the Administration’s clear focus and broader position on these contracting practices. Sheppard’s Antitrust and Healthcare groups are closely following these developments, and healthcare industry stakeholders should note this increased scrutiny on contracting practices and review their existing contracts and compliance programs accordingly.
FOOTNOTES
[1] Effects of Banning Anti-Competitive Hospital Contracts, Whitehouse.gov (June 18, 2026), https://www.whitehouse.gov/research/2026/06/effects-of-banning-anti-competitive-hospital-contracts/.
[2] Compl., United States v. OhioHealth Corp., No. 2:26-cv-207 (Feb. 20, 2026 S.D. Ohio), ECF No. 1.
[3] Not. of Settlement & Exhibit Prop. Final Judgment, United States v. OhioHealth Corp., No. 2:26-cv-207 (June 16, 2026 S.D. Ohio), ECF Nos. 29 & 29-2.
[4] U.S. Department of Justice (@TheJusticeDept), X (June 18, 2026 7:03 PM), https://x.com/JusticeATR?lang=en]
[5] Effects of Banning Anti-Competitive Hospital Contracts, Whitehouse.gov (June 18, 2026), https://www.whitehouse.gov/research/2026/06/effects-of-banning-anti-competitive-hospital-contracts/.
[6] See also Savings from Most-Favored-Nation (MFN) Drug Pricing Policy, Whitehouse.gov (May 5, 2026), https://www.whitehouse.gov/research/2026/05/savings-from-most-favored-nation-drug-pricing-policy/.
[7] See, e.g., Nev. Rev. Stat. §. 598A.440; Mass. Gen. Laws 176O § 9A; Tex. Ins. Code § 1458.101.
[8] Justice Department Requires OhioHealth to Stop Using Anticompetitive Healthcare Contract Terms That Raise Costs for Ohio Patients, Office of Public Affairs U.S. Dep’t of Justice (June 16, 2026), https://www.justice.gov/opa/pr/justice-department-requires-ohiohealth-stop-using-anticompetitive-healthcare-contract-terms.