DOJ Prioritizes Antitrust Enforcement Against Large Health Systems For Payor Contracting Practices

In what is now a trend, on March 26, 2026, the United States Department of Justice Antitrust Division (DOJ) filed an antitrust lawsuit against The New York and Presbyterian Hospital challenging its contracting practices with commercial health insurers (or payors). The lawsuit alleges that the hospital system used its market power to contractually restrict payors from offering health plans featuring lower-cost rival hospitals. The complaint is very similar to one filed by the DOJ and the State of Ohio against OhioHealth, the largest hospital system in central Ohio, in February. Both cases allege that the defendant hospital system’s restrictions prevent payors from introducing “budget-conscious plans” to the relevant markets, including through narrow networks and tiering. These enforcement actions make clear that the DOJ Antitrust Division is focused on certain payor contracting practices of large health systems, including “all or nothing” and anti-steering provisions, even when those