DOJ targets hospital contracts barring competitors from top insurance tiers

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The U.S. Justice Department is suing North Carolina’s largest healthcare system, saying it illegally imposes contract requirements on insurers that reduce competition.

Carolinas HealthCare System places restrictions in its contracts with insurers that bar them from offering tiered networks that include competing hospitals in their top tiers, the Justice Department and the state of North Carolina allege in a complaint filed Thursday. The system also forbids the insurers from offering narrow networks that include only its competitors in violation of antitrust law, according to the Justice Department.

Carolinas HealthCare System said in a statement Thursday that such arrangements with insurers are similar to others between insurers and healthcare systems across the country.

“We have neither violated any law nor deviated from accepted healthcare industry practices for contracting and negotiation,” the system said. “In fact, we have been applauded by the U.S. government for the quality care and cost reduction programs we’ve implemented, programs it hopes to model in other parts of the country.”

Read the full article: Modern Healthcare

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