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Justice Department Sues NewYork-Presbyterian Over Contract Terms That Block Cheaper Health Plans

The government seeks a court order to bar plan design limits that it argues keep prices high.

Overview

  • The Justice Department, which filed the Sherman Act case Thursday in the Southern District of New York, asked a judge to halt the restrictions.
  • Prosecutors say the hospital bars insurers from selling plans that exclude it or that offer better copays or top-tier placement at rival hospitals.
  • The complaint says the city’s largest hospital system demands all-or-nothing deals that force health plans to include its entire network to gain any access.
  • The filing describes an insurer that was stopped from moving outpatient colonoscopies to a lower-cost provider.
  • NewYork-Presbyterian calls the suit meritless and says insurers hold the power, as the case grows from a 2024 union complaint and wider federal scrutiny of hospital contracts.