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Atrium DOJ Agreement Announcement
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Settlement: Hospital group to stop anticompetitive measures
Nov 15, 2018 | Associated Press
By Jonathan Drew
A dominant North Carolina hospital system has agreed to halt insurance practices that hindered patients from finding better health care deals, prosecutors said Thursday. -
N.C. hospital system settles antitrust allegations
Nov 15, 2018 | AXIOS
By Bob Herman
Atrium Health, a dominant hospital system based in North Carolina, has agreed to a settlement with the Department of Justice and North Carolina's attorney general that will prohibit the system from imposing anticompetitive terms with health insurers that raise costs for consumers. -
Health care system settles Justice Department's antitrust lawsuit
Nov 15, 2018 | Washington Times
By Jeff Mordock
One of the largest nonprofit health care systems in the Untied States on Thursday settled a Justice Department lawsuit alleging it negotiated unlawful contacts that prevented patients from accessing less expensive physicians and hospitals. -
Atrium Health settles anti-steering contract suit with feds
Nov 15, 2018 | Modern Healthcare
By Shelby Livingston
The U.S. Justice Department said it has reached a settlement with Atrium Health that would prohibit the Charlotte, N.C.-based hospital system from using anticompetitive steering restrictions in contracts between commercial health insurers and its providers. -
Atrium Health agrees to settle antitrust lawsuit over contract language
Nov 15, 2018 | Fierce Healthcare
By Tina Reed
North Carolina-based Atrium Health reached a settlement with the Justice Department over what the DOJ called "anticompetitive steering restrictions" in contracts between its providers in the Charlotte metropolitan area and commercial health insurers. -
DOJ Cuts Deal With Hospital In Patient-Steering Suit
Nov 15, 2018 | Law360
By Anne Cullen
The U.S. Department of Justice announced Thursday it has struck a deal with a North Carolina hospital system in the department’s suit alleging the health care network used its stronghold in the local market to keep major health insurers from informing patients about lower-cost hospitals. -
Atrium Health, DOJ Settle Antitrust Lawsuit
Nov 15, 2018 | Health Leaders
By John Commins
Federal prosecutors had alleged that Atrium's restrictions on coverage options prevented insurers from promoting cost-effective healthcare services. Atrium admits no wrongdoing. -
Settlement between DOJ, Atrium Health aims to improve patient service
Nov 15, 2018 | WSOCTV
By Jason Stoogenke
The Department of Justice announced Thursday morning that it has reached a settlement with Atrium Health (formerly known as Carolinas HealthCare System) over an anti-competition lawsuit. -
Atrium Health agrees to settle antitrust lawsuit addressing contract restrictions
Nov 15, 2018 | Winston-Salem Journal
By Richard Craver
Atrium Health, the main competitor of Novant Health Inc. in Charlotte, has agreed to settle an antitrust lawsuit with the N.C. and U.S. justice departments. -
Justice Department, Atrium Health reach settlement in antitrust lawsuit
Nov 15, 2018 | CBJ
By Caroline Hudson
Atrium Health and the U.S. Department of Justice have reached a settlement on a lawsuit challenging the Charlotte-based provider's anticompetitive restrictions. Atrium can no longer use steering restrictions in contracts between commercial health insurers and insurance providers in the Charlotte area. -
Atrium Health, North Carolina to settle antitrust suit over health care costs
Nov 15, 2018 | Charlotte Observer
By Cassie Cope & Ames Alexander
North Carolina and federal authorities say they plan to settle their antitrust allegations against Atrium Health, reaching an agreement that they say will lower health care prices for hospital patients. -
BREAKING: Atrium Health Reaches Settlement With Department Of Justice
Nov 15, 2018 | WFAE
By Alex Olgin
Atrium Health and the North Carolina and United States Justice Departments have settled a 2016 antitrust lawsuit about healthcare pricing. -
DOJ Reaches Proposed Settlement in Anti Steering Case Against Atrium Health
Nov 16, 2018 | National Law Review
By Bruce D. Sokler & Farrah Short
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Nov 15, 2018 | Charlotte, NC
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Nov 15, 2018 | Charlotte, NC
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Nov 15, 2018 | Charlotte, NC
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Nov 15, 2018 | WUNCFM (Radio)
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Nov 15, 2018 | WFDD - NPR
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Settlement: Hospital group to stop anticompetitive measures
Nov 15, 2018 | Associated Press
By Jonathan Drew
A dominant North Carolina hospital system has agreed to halt insurance practices that hindered patients from finding better health care deals, prosecutors said Thursday.
The U.S. Justice Department announced that Atrium Health agreed to a settlement that prohibits the Charlotte-based system from including certain anticompetitive measures in its contracts with health insurers. Prosecutors said the contract restrictions had kept insurers from encouraging patients to find the most cost-effective hospitals and doctors.
The settlement will get rid of "restrictions that curb comparison shopping and interfere with competition," said Makan Delrahim, an assistant attorney general with the U.S. Justice Department.
North Carolina Attorney General Josh Stein, whose office had sued Atrium alongside federal prosecutors, said the settlement will give consumers the ability to find care at a lower cost and to get more transparency about prices.
"We can't allow Atrium to use its size and market dominance to the detriment of healthcare consumers," he said in a statement.
The federal antitrust lawsuit filed in 2016 argued that the hospital chain formerly known as Carolinas HealthCare System had used its market power to keep consumers from exploring options that offered better value.
Atrium Health issued a statement Thursday saying it didn't violate the law and noting the settlement includes no admission of wrongdoing or payment of any fines. Atrium Health said the contract language subject to litigation dates to 2001 and was originally created to ensure that it could compete equally for patients.
"Atrium Health has always been a champion for patient choice," the not-for-profit company said.
The health care system, described by the Justice Department as the largest in North Carolina and a dominant provider in Charlotte, also has locations in South Carolina and on the North Carolina coast. The flagship of the system's nine hospitals in Charlotte, Carolinas Medical Center, is the largest in the city, according to the Justice Department.
The settlement will be subject to a public-comment period and must be approved by a federal court.
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N.C. hospital system settles antitrust allegations
Nov 15, 2018 | AXIOS
By Bob Herman
Atrium Health, a dominant hospital system based in North Carolina, has agreed to a settlement with the Department of Justice and North Carolina's attorney general that will prohibit the system from imposing anticompetitive terms with health insurers that raise costs for consumers.
The big picture: Atrium Health is not the only hospital system that has used these kinds of "anti-steering" contracts, which attempt to suppress competition from lower-cost providers, and it's worth watching whether the federal government and states take more actions.
Details: Atrium, formerly known as Carolinas HealthCare, has to notify Aetna, Blue Cross Blue Shield of North Carolina, Cigna, MedCost and UnitedHealthcare of the terms.Moving forward, Atrium cannot draft contracts that would penalize those insurers for creating narrow networks that exclude Atrium's hospitals and doctors or would prevent insurers from disclosing prices to employers and patients.Atrium also can't dictate how insurers include competing providers in their networks.Atrium does not face any monetary penalties and did not admit any wrongdoing. The system downplayed the contracts as old and said in a statement it was "a champion for patient choice."
Yes, but: The settlement expires after 10 years.
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Health care system settles Justice Department's antitrust lawsuit
Nov 15, 2018 | Washington Times
By Jeff Mordock
One of the largest nonprofit health care systems in the Untied States on Thursday settled a Justice Department lawsuit alleging it negotiated unlawful contacts that prevented patients from accessing less expensive physicians and hospitals.
Atrium Health, formerly known as Carolinas HealthCare System, settled the lawsuit to resolve nearly two years of litigation over its contracts with health insurers. The Justice Departmentalleged in the lawsuit tens of thousands of patients were forced to pay more for inpatient hospital care.
Under the settlement, expected to be approved by a federal judge Thursday, there is no admission of wrongdoing or legal violations by Atrium. It will not pay any fines.
Atrium said in a statement Thursday that the dispute was over language in contracts that dated back as far as 2001 and was added to even the playing field for hospitals looking for patients.
“As the healthcare landscape continues to rapidly evolve, Atrium Health’s contracting language has also evolved to reflect current healthcare practices,” the company said in a statement.
But the Justice Department said in legal papers that Atrium used its position as one of the largest health care systems to force customers into footing a larger bill than necessary. The department said Atrium engaged in steering restrictions, an industry term for offering financial incentives to customers for selecting less expensive health care options.
“Competition encourages health care providers to reduce costs, lower prices, and increase quality,” said Assistant Attorney General Makan Delrahim. “Atrium’s steering restrictions interfered with the competitive process, resulting in fewer choices and higher costs for consumers.”
Under the proposed settlement, Atrium is barred from enforcing steering restrictions in its contracts.
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Atrium Health settles anti-steering contract suit with feds
Nov 15, 2018 | Modern Healthcare
By Shelby Livingston
The proposed settlement, which was filed Thursday in U.S. District Court for the Western District of North Carolina and must be approved by the court, also bars Atrium from seeking contract terms or taking action that would prevent or penalize steering by insurers in the future.
"With healthcare costs rising, vigilant antitrust enforcement is an essential tool for protecting consumers," Assistant Attorney General Makan Delrahim said in a news release announcing the settlement. "By eliminating restrictions that curb comparison shopping and interfere with competition among healthcare providers, today's resolution of our antitrust action allows consumers in the Charlotte area to benefit from competition when making critically important healthcare choices."
Atrium said in a statement that the anti-steering language in question is from contracts created as long ago as 2001 and was added to "ensure Atrium Health was provided an equal opportunity to compete for patients." Atrium said it contracts with insurers have evolved since then to reflect current practices. It also noted that the settlement is not an admission of wrongdoing and will not be required to pay fines or penalties.
The Justice Department sued Atrium Health, which was then called Carolinas HealthCare System, in June 2016 for allegedly violating antitrust law by including steering restrictions in contracts with insurers that ultimately raised prices for patients. The case is one of the first from the Justice Department targeting anti-steering provisions in hospital contracts.
Steering is a strategy used by insurers to direct patients to certain healthcare providers. Insurers are increasingly designing health plans that give consumers financial incentives to choose more cost-effective doctors and hospitals, which helps increase competition between providers to offer lower costs and better services, according to the Justice Department.
Steering can include tiered and narrow networks, in which insurers allow their members to pay less out of pocket when they choose top-tier providers or seek care within the narrow network. The Justice Department argued that steering gives providers a big incentive to be efficient, maintain low prices and offer high quality, innovative healthcare services to induce insurers to steer patients to them.
But the feds claimed that Atrium—the largest healthcare system in North Carolina with net operating revenue of $9.9 billion in 2017—used its market power to force insurers into contracts that prevented them from steering patients to less costly providers, which would have encouraged competition that would potentially require Atrium to lower its prices. In its 2016 complaint, the Justice Department said Atrium Health "has long had a reputation for being a high-priced healthcare provider."
The Justice Department claimed Atrium included restrictions on steering in its contracts with Aetna, Blue Cross and Blue Shield of North Carolina, Cigna Corp. and UnitedHealthcare, which together insured 85% of the commercially-insured people in the Charlotte area. The restrictions varied with each insurer but sometimes granted Atrium the right to terminate the contract if the insurer steered patients to competitors, the feds alleged.
They also claimed that Atrium prevented insurers from providing truthful cost and quality information about its healthcare services compared to its competitors, limiting patients' ability to shop for the best deals.
These actions reduced competition because without the promise of attracting more patients, Atrium's competitors have less incentive to offer lower prices or increase efficiency, the Justice Department said. Insurers did not want the restrictions but were compelled to accept them because of the Atrium's dominant market position. As a result, the feds said individuals and employers in Charlotte pay higher prices for insurance and have fewer options for healthcare.
Atrium, however, argued that the anti-steering provisions served to prevent the insurance companies from promising to provide insured customers and then encouraging those customers to avoid Atrium services. Its attorneys also claimed that their arrangements with the insurers promote competition because the health system is providing discounted services in exchange for "customer loyalty." -
Atrium Health agrees to settle antitrust lawsuit over contract language
Nov 15, 2018 | Fierce Healthcare
By Tina Reed
North Carolina-based Atrium Health reached a settlement with the Justice Department over what the DOJ called "anticompetitive steering restrictions" in contracts between its providers in the Charlotte metropolitan area and commercial health insurers.
Formerly known as Carolinas HealthCare System, Atrium will resolve more than two years of civil antitrust litigation over contract provisions that blocked health insurers from promoting innovative health benefit plans and cost-effective services to consumers if a court approves the deal.
That deal includes an agreement barring Atrium from seeking contract terms or taking actions that would prohibit, prevent, or penalize steering by insurers in the future. It comes less than a month after Senate Judiciary Committee Chairman Chuck Grassley called for the Federal Trade Commission to examine "potentially anticompetitive contracting practices between insurers and hospital systems" including Atrium.
“With healthcare costs rising, vigilant antitrust enforcement is an essential tool for protecting consumers,” Assistant Attorney General Makan Delrahim said in a statement. “By eliminating restrictions that curb comparison shopping and interfere with competition among healthcare providers, today’s resolution of our antitrust action allows consumers in the Charlotte area to benefit from the competition when making critically important healthcare choices.”
In a statement, Atrium officials said the settlement involves no admission of wrongdoing on the part of Atrium Health and will not require the health system to pay any penalties or fines.
"The language in question is from contracts created as long ago as 2001 and was originally added to ensure Atrium Health was provided an equal opportunity to compete for patients," officials said in the statement. "As the healthcare landscape continues to rapidly evolve, Atrium Health’s contracting language has also evolved to reflect current healthcare practices."
The DOJ filed its civil antitrust lawsuit against Atrium in June 2016 alleging Atrium, the dominant hospital system in the Charlotte area, used its market power to restrict health insurers from encouraging consumers to choose healthcare providers that offer better overall value.Earlier this year, Carolinas HealthCare System, the largest health system in North Carolina, announced it was changing its name to Atrium Health after merging with Navicent Health. In March, however, it announced that negotiations for another merger with UNC Health Care fell apart. In April, it released a medical group after providers sued to be released from its contract with the health system for "anticompetitive actions."
The health system has also been in the midst of expansion, planning to build new medical office space in a $250 million downtown space and a $116 million hospital building in Union County outside of Charlotte. In June, it announced it would increase its minimum wage from $11.50 per hour to $12.50 per hour for 7,500 staffers in the Charlotte area.
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DOJ Cuts Deal With Hospital In Patient-Steering Suit
Nov 15, 2018 | Law360
By Anne Cullen
The U.S. Department of Justice announced Thursday it has struck a deal with a North Carolina hospital system in the department’s suit alleging the health care network used its stronghold in the local market to keep major health insurers from informing patients about lower-cost hospitals.
The settlement, which hit the docket Thursday morning, prevents Atrium Health, formerly known as Carolinas HealthCare System, from enforcing these steering restrictions in its existing contracts with major insurance companies, putting an end to more than two years of litigation.
Atrium also can’t include any more of these anti-competitive restrictions in its contracts or penalize insurers that encourage consumers with financial incentives to use more cost-effective health care options, according to the deal.
The attorney general for North Carolina, who brought the suit alongside federal prosecutors, told Law360 on Thursday that the settlement will help balance Charlotte’s health care playing field.
“I’m excited about what the U.S. Department of Justice and my office have achieved to benefit consumers of health care in the Charlotte area,” Josh Stein said. “As a result of our settlement with Atrium, consumers should see lower prices for high-quality care and greater transparency of the cost of their health care.”
Atrium said in a statement that it's pleased with what it called a mutually acceptable conclusion to the lawsuit, and emphasized that the deal doesn't include any admission of wrongdoing or illegal behavior, or any penalties or fines.
The hospital system added that the contract language at the focal point of the litigation was written in some cases nearly 20 years ago to ensure it could stay competitive.
"The language in question is from contracts created as long ago as 2001 and was originally added to ensure Atrium Health was provided an equal opportunity to compete for patients," Atrium said. "As the healthcare landscape continues to rapidly evolve, Atrium Health’s contracting language has also evolved to reflect current healthcare practices."
The DOJ and the state launched the allegations in mid-2016 and scored a key win in the suit last year, when a North Carolina federal judge refused to toss the suit after finding the steering restrictions plausibly drove up insurance prices and cut down consumer choices.
U.S. District Judge Robert J. Conrad Jr.’s ruling also rejected the hospital’s assertion that a Second Circuit decision shielding similar restrictions used by American Express Co. undermined prosecutors’ arguments.
The health care system — which is the largest in North Carolina and one of the largest in the country — operates nine acute-care hospitals in the Charlotte area and is affiliated with more than 40 in the Carolinas as a whole, the department said in its announcement. Last year, these hospitals recorded a net operating revenue of nearly $10 billion, the department said.
The deal stipulates that Atrium must abide by the provisions before final judgment is issued, which will come after the settlement is logged in the Federal Register for a 60-day comment period as required by antitrust law.
Once a final order has been handed down, Atrium has 15 days to notify Aetna Inc., Cigna Corp. and other major health insurers that steering restrictions in their existing contracts are now void.
The Department of Justice declined to submit additional comment aside from the press release.
The U.S. is represented by John R. Read, Karl D. Knutsen, Natalie Melada, Catherine R. Reilly, David M. Stoltzfus, Paul Torzilli, and Eric D. Welsh of the Department of Justice.
North Carolina is represented by Josh Stein and K.D. Sturgis of the state's Department of Justice.
Atrium is represented by James P. Cooney III, Sarah Stone, Debbie W. Harden, Mark J. Horoschak, Brian Hayles, Matthew Tilley, and Michael Fischer of Womble Bond Dickinson (US) LLP, and Richard A. Feinstein, Wells Harrell, Nicholas A. Widnell, Hampton Dellinger and Sean Johnson of Boies Schiller & Flexner LLP.
The case is United States of America et al. v. The Charlotte-Mecklenburg Hospital Authority, case number 3:16-cv-00311, in the U.S. District Court for the Western District of North Carolina. -
Atrium Health, DOJ Settle Antitrust Lawsuit
Nov 15, 2018 | Health Leaders
By John Commins
Federal prosecutors had alleged that Atrium's restrictions on coverage options prevented insurers from promoting cost-effective healthcare services. Atrium admits no wrongdoing.
KEY TAKEAWAYS:
Atrium allegedly used its market power to restrict health insurers from promoting coverage options for consumers.
The Charlotte-based health system says the problem arose from obsolete language in older contracts.
The settlement awaits the approval of a federal judge.
Atrium Health has agreed to end what the federal government said are anticompetitive steering restrictions in contracts between commercial health insurers and its providers in the Charlotte, North Carolina service area, the Department of Justice announced. If the settlement is approved by a federal judge, it will end two years of civil antitrust litigation that challenged Atrium's alleged use of steering restrictions that prevented health insurers from promoting cost-effective healthcare services to consumers, DOJ said.
"Competition encourages healthcare providers to reduce costs, lower prices, and increase quality," said Makan Delrahim, Assistant U.S. Attorney General for the Antitrust Division. "Atrium's steering restrictions interfered with the competitive process, resulting in fewer choices and higher costs for consumers."
DOJ claimed that Atrium, the dominant provider in Charlotte, used its market power to restrict health insurers from encouraging consumers to choose healthcare providers that offer better value. The restrictions also constrained insurers from providing consumers and employers with information regarding the cost and quality of alternative health benefit plans, DOJ said.
Atrium issued a statement noting that there was "no admission on the part of Atrium Health of wrongdoing in this settlement agreement, and Atrium Health did not violate the law. In addition, Atrium Health will not pay any penalties or fines.
"The language in question is from contracts created as long ago as 2001 and was originally added to ensure Atrium Health was provided an equal opportunity to compete for patients," Atrium said. "As the healthcare landscape continues to rapidly evolve, Atrium Health's contracting language has also evolved to reflect current healthcare practices."
Atrium is North Carolina's largest healthcare system and one of the largest not-for-profit healthcare systems in the United States. Atrium's flagship Carolinas Medical Center is the largest hospital in North Carolina. Atrium also operates eight other general acute-care hospitals in the Charlotte area and owns, manages, or has strategic affiliations with more than 40 hospitals in the Carolinas. In 2017, Atrium's owned, managed, and affiliated hospitals and other healthcare providers earned net operating revenue of close to $10 billion.
“Competition encourages healthcare providers to reduce costs, lower prices, and increase quality. Atrium's steering restrictions interfered with the competitive process, resulting in fewer choices and higher costs for consumers.” - Makan Delrahim, assistant US attorney general for the antitrust division
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Settlement between DOJ, Atrium Health aims to improve patient service
Nov 15, 2018 | WSOCTV
By Jason Stoogenke
The Department of Justice announced Thursday morning that it has reached a settlement with Atrium Health (formerly known as Carolinas HealthCare System) over an anti-competition lawsuit.
It started in 2016 when the US DOJ, as well as North Carolina's Department of Justice, sued Carolinas Healthcare System -- which is now Atrium Health.
“As a result of this settlement, people will be able to purchase lower cost, high quality healthcare and gain transparency of healthcare pricing,” said North Carolina Attorney General Josh Stein. “We can’t allow Atrium to use its size and market dominance to the detriment of healthcare consumers.”
The settlement prohibits Atrium from using anticompetitive steering restrictions in contracts between commercial health insurers and its providers in the Charlotte area.
Atrium Health officials said there is no admission on their part of wrongdoing in the settlement agreement, and Atrium Health did not violate the law. Also, Atrium Health will not pay any penalties or fines.
If approved by the court, the settlement resolves over two years of civil antitrust litigation challenging Atrium’s use of steering restrictions that prevent health insurers from promoting innovative health benefit plans and more cost-effective healthcare services to consumers.
“With healthcare costs rising, vigilant antitrust enforcement is an essential tool for protecting consumers,” said Assistant Attorney General Makan Delrahim. “By eliminating restrictions that curb comparison shopping and interfere with competition among healthcare providers, today’s resolution of our antitrust action allows consumers in the Charlotte area to benefit from competition when making critically important healthcare choices.”
In June 2016, the DOJ filed a civil antitrust lawsuit against Atrium challenging provisions that prohibit steering in the hospital system’s contracts with major health insurers.
Steering is a method used by insurers to offer consumers options to reduce some of their healthcare expenses. As alleged in the complaint, insurers are increasingly designing health benefit plans that give patients financial incentives to choose more cost-effective hospitals and physicians.
Increased consumer access to these health benefit plans invigorates competition between providers to offer lower premiums and better overall healthcare services.
The DOJ alleged that Atrium used its market power to restrict health insurers from encouraging consumers to choose healthcare providers that offer better overall value. It said the restrictions also constrained insurers from providing consumers and employers with information regarding the cost and quality of alternative health benefit plans.
“Competition encourages healthcare providers to reduce costs, lower prices, and increase quality,” said Delrahim. “Atrium’s steering restrictions interfered with the competitive process, resulting in fewer choices and higher costs for consumers.”
Atrium Health officials said they have always been a champion for patient choice, and believe Atrium's quality, value and services are the reason why more people continue to choose them over any other healthcare provider in the region.
“The resolution of this antitrust enforcement action gives Charlotte-area consumers what they did not have before: the ability to receive the appropriate, high-quality treatment they need, from a healthcare provider they choose, at a fair price,” said U.S. Attorney for the Western District of North Carolina, R. Andrew Murray. “Today’s enforcement action will restore competition in the Charlotte area, resulting in lower healthcare costs and increased healthcare access for consumers and their families.”
The proposed settlement also bars Atrium from seeking contract terms or taking actions that would prohibit, prevent, or penalize steering by insurers in the future.
Atrium is North Carolina’s largest healthcare system and one of the largest not-for-profit healthcare systems in the United States. Atrium’s flagship facility is Carolinas Medical Center, the largest hospital in North Carolina.
Atrium also operates eight other general acute-care hospitals in the Charlotte area and owns, manages, or has strategic affiliations with more than 40 hospitals in the Carolinas.
In 2017, Atrium’s owned, managed, and affiliated hospitals and other healthcare providers earned net operating revenue of close to $10 billion.
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Atrium Health agrees to settle antitrust lawsuit addressing contract restrictions
Nov 15, 2018 | Winston-Salem Journal
By Richard Craver
Atrium Health, the main competitor of Novant Health Inc. in Charlotte, has agreed to settle an antitrust lawsuit with the N.C. and U.S. justice departments.
The lawsuit was filed in June 2016 against Atrium, then-known as Carolinas Health Care, and Charlotte-Mecklenburg Hospital Authority.
The settlement was announced Thursday.
At the time of the lawsuit, Carolinas had a 50 percent market share in the Charlotte metropolitan area, which consists of nine counties in North Carolina and three in South Carolina.
According to the N.C. Attorney General’s office, Atrium was accused of violating the federal Sherman Act by using restrictions that “unreasonably restrain trade.”
The plaintiffs asked that a federal judge for the Western District of North Carolina bar Carolinas from “using unlawful contract restrictions” known as steering.
Those restrictions can limit or prohibit insurers from sending customers to other health-care providers who may offer lower-cost services. In exchange, the systems offer discounts to providers and insurers.
Steering requirements “prohibit commercial health insurers in the Charlotte area from offering patients financial benefits to use less expensive health-care services offered by CHS’ competitors,” the agencies claim.
Attorney General Josh Stein said in a statement Thursday that "as a result of this settlement, people will be able to purchase lower-cost, high-quality healthcare and gain transparency of healthcare pricing."
“We can’t allow Atrium to use its size and market dominance to the detriment of healthcare consumers.”
The settlement requires Atrium to notify insurance providers within 15 business days that it will no longer enter into or enforce contracts that violate the above terms.
“The resolution of this antitrust enforcement action gives Charlotte-area consumers what they did not have before: the ability to receive the appropriate, high-quality treatment they need, from a healthcare provider they choose, at a fair price,” U.S. attorney Andrew Murray said.
Atrium's initial response to the lawsuit in August 2016was to ask for its dismissal. It said the complaint “fails to sufficiently allege actual competitive harm in the marketplace" and its steering practices contributed to lower health-care costs in the Charlotte market.
The agencies cited as examples of the harm caused by Carolinas’ steering practices as “reducing choice among fewer insurance plans, offering fewer price shopping and other comparison tools, and reducing output.”
Atrium said in a statement Thursday "there is no admission on the part of Atrium Health of wrongdoing in this settlement agreement, and Atrium Health did not violate the law. In addition, Atrium Health will not pay any penalties or fines."
"Atrium Health has shared its perspective and position with the DOJ and the North Carolina Office of Attorney General, and is pleased to be able to reach a mutually acceptable settlement agreement."
Novant said in a statement it "doesn't provide comment on the business practices of other organizations.”
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Justice Department, Atrium Health reach settlement in antitrust lawsuit
Nov 15, 2018 | CBJ
By Caroline Hudson
Atrium Health and the U.S. Department of Justice have reached a settlement on a lawsuit challenging the Charlotte-based provider's anticompetitive restrictions. Atrium can no longer use steering restrictions in contracts between commercial health insurers and insurance providers in the Charlotte area.
Steering refers to a practice where an insurer offers consumers financial incentives to use lower-cost providers.
DOJ and the state of North Carolina filed a civil antitrust lawsuit against Atrium in June 2016, alleging the health-care system's steering restrictions on insurers prevented consumers from having access to lower-cost care and more care options.
“Competition encourages health-care providers to reduce costs, lower prices and increase quality,” says Assistant Attorney General Makan Delrahim. “Atrium’s steering restrictions interfered with the competitive process, resulting in fewer choices and higher costs for consumers.”
Atrium was then known as Carolinas HealthCare System.
Atrium, which is Charlotte's largest health-care provider, maintains it did nothing wrong and did not violate the law. Atrium was not ordered to pay any penalties or fees.
"The language in question is from contracts created as long ago as 2001 and was originally added to ensure Atrium Health was provided an equal opportunity to compete for patients," Atrium says in a statement. "Atrium Health believes in and welcomes competition based on value."
Atrium previously had steering restrictions in contracts with Aetna Health of the Carolinas, Blue Cross and Blue Shield of North Carolina, Cigna Healthcare of North Carolina and United Healthcare of North Carolina.
The initial filing in 2016 stated that insurers tried to negotiate for the removal of steering restrictions but were unable to because of Atrium's market power.
Atrium reported net operating revenue of almost $10 billion in 2017. It is the second-largest metro-area employer in North Carolina with roughly 53,000 employees.
The proposed settlement was submitted today to the U.S. District Court for the Western District of North Carolina for approval.
“Today’s enforcement action will restore competition in the Charlotte area, resulting in lower health-care costs and increased health-care access for consumers and their families,” says R. Andrew Murray, U.S. attorney for the Western District of North Carolina.
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Atrium Health, North Carolina to settle antitrust suit over health care costs
Nov 15, 2018 | Charlotte Observer
By Cassie Cope & Ames Alexander
North Carolina and federal authorities say they plan to settle their antitrust allegations against Atrium Health, reaching an agreement that they say will lower health care prices for patients.
The 2016 antitrust lawsuit filed against Atrium Health, formerly Carolinas HealthCare System, alleged that the multi-billion-dollar hospital chain illegally reduced competition in the Charlotte health care market.
In the proposed settlement of the suit, Atrium will be banned from entering into contracts with insurance companies that would limit transparency and curb the ability of insurers to offer lower cost benefit plans.
“By eliminating restrictions that curb comparison shopping and interfere with competition among healthcare providers, today’s resolution of our antitrust action allows consumers in the Charlotte area to benefit from competition when making critically important healthcare choices,” said Assistant U.S. Attorney General Makan Delrahim.
In a separate statement, N.C. Attorney General Josh Stein agreed: “We can’t allow Atrium to use its size and market dominance to the detriment of healthcare consumers ... Together, we have been able to achieve greater competition and price transparency for healthcare consumers in the Charlotte area.”
Atrium is North Carolina’s largest health care system and Charlotte’s largest employer. It operates Carolinas Medical Center and 43 other hospitals. With nearly $6 billion in operating revenue last year, it is one of the nation’s largest nonprofit health care systems.
In a statement issued Thursday, Atrium admitted no wrongdoing and said it did not violate the law. The system will pay no penalties or fines as part of the settlement, Atrium said.
“Atrium Health has always been a champion for patient choice, and believes its unparalleled quality, value and world-class services are the reason why more people continue to choose Atrium Health over any other healthcare provider in the region,” the system said in its news release. “Atrium Health’s focus remains on providing an individualized care experience for the thousands of patients who rely on its services for health, hope and healing each and every day.”Dwarfing its competitors
Atrium’s closest competitor is Novant Health, which owns five hospitals in the Charlotte area and has less than half of Atrium’s revenue, the lawsuit said at the time.
Atrium used its dominance to get its way with insurers, the lawsuit alleged.
In a 2012 investigation, The Charlotte Observer and The (Raleigh) News & Observer found that Atrium and other large nonprofit hospitals in North Carolina have pushed up health care costs, paid executives millions and left thousands with bills they struggle to pay.
The lawsuit alleged that Atrium used its market power to negotiate “unlawful contract restrictions,” which prevent consumers from taking advantage of lower prices at other hospitals, the Observer reported in 2016. The lawsuit also contended that Atrium encouraged insurers to steer patients its way and used its influence to prevent insurers from giving the same deal to competing hospitals.
Under the proposed settlement, Atrium will be banned from:Restricting insurance companies from offering consumers financial incentives to use lower-cost, high-quality providers.Preventing insurers from disclosing health care prices to consumers.Requiring insurers to get Atrium’s approval before introducing lower-cost benefit plans.Atrium: We welcome competition
The suit contended Atrium has “long had a reputation for being a high-priced healthcare provider.” In a 2013 presentation, an internal strategy group recognized that Atrium “has enjoyed years of annual reimbursement rate increases that are premium to the market,” the lawsuit states.
In its Thursday statement, Atrium said it “welcomes competition based on value. Competition drives improvements in healthcare quality and services – ultimately benefiting every patient.”
The settlement will become final once it is approved by the courts.
“The resolution of this antitrust enforcement action gives Charlotte-area consumers what they did not have before: the ability to receive the appropriate, high-quality treatment they need, from a healthcare provider they choose, at a fair price,” said Andrew Murray, U.S. Attorney for the Western District of North Carolina. “Today’s enforcement action will restore competition in the Charlotte area, resulting in lower healthcare costs and increased healthcare access for consumers and their families.”
A separate class-action lawsuit, filed on behalf of three former Atrium patients, is still being litigated. That suit also alleges that Atrium engaged in illegal and anti-competitive actions that have resulted in higher insurance premiums for many people.
“We are grateful to the Justice Department and North Carolina Attorney General lawyers for their work on behalf of the people of North Carolina,” said Brendan Glackin, a San Francisco lawyer who is representing the former patients. “We will continue to press forward on our case to achieve monetary relief for the same people.”
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BREAKING: Atrium Health Reaches Settlement With Department Of Justice
Nov 15, 2018 | WFAE
By Alex Olgin
Atrium Health and the North Carolina and United States Justice Departments have settled a 2016 antitrust lawsuit about healthcare pricing.
The suit, filed more than two years ago, claimed that Atrium Health had agreements in place with insurers that would prevent them from incentivizing patients to find more affordable care at other competitors within the Charlotte market.
The healthcare giant, formerly Carolinas HealthCare System, does not admit any wrongdoing in the settlement and said that it is not required to pay any penalties or fines.
The proposed agreement will prohibit Atrium from entering contracts with insurance companies that would prevent or punish insurance companies from sharing price details with patients. The contracts can also no longer require Atrium to be in the highest tier of plans, even if those plans don’t meet price or other health care value criteria.
Atrium is also prohibited from force insurers to gain approval before introducing or offering incentives for patients to use other hospitals or doctors at a lower cost.
“As a result of this settlement, people will be able to purchase lower cost, high quality healthcare and gain transparency of healthcare pricing," Attorney General Josh Stein said in a statement Thursday. "We can’t allow Atrium to use its size and market dominance to the detriment of healthcare consumers.”
Atrium said in a separate statement that the language in question was from 2001 contracts and that it was "originally added to ensure Atrium Health was provided an equal opportunity to compete for patients."
"As the healthcare landscape continues to rapidly evolve, Atrium Health’s contracting language has also evolved to reflect current healthcare practices."
Stein said that the settlement, still awaiting final approval from the judge, will require Atrium to notify insurance providers within 15 business days that it will no longer enter into or enforce old contracts that are now prohibited.
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DOJ Reaches Proposed Settlement in Anti Steering Case Against Atrium Health
Nov 16, 2018 | National Law Review
By Bruce D. Sokler & Farrah Short
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WSOC - Eyewitness News Midday (Television)
Nov 15, 2018 | Charlotte, NC
By WSOC (ABC)
Video Link: https://app.criticalmention.com/app/#clip/view/541acfcf-d450-48a4-bbe9-87f7f232148b?token=50743fe7-d6ce-4a1f-8f67-f1632bb8c935
Rough Transcript: breaking news right now that impacts the price you pay for health care. atrium, the u.s. department of justice and the north carolina department of justice have just settled a major lawsuit. jason has covered this suit from when this was filed. cut through the legalese so you know what it means for you. >> reporter: means for you. >> reporter: the bottom line means this should be good for patients in the charlotte area. this means more services and lower costs. this means the department of justice and north carolina department of justice sued the health care system atrium. it's the largest health care system in the state. it's the largest not nor profit systems in the country. it has ties to more than 40 hospitals in the carolinas and last year it ran $10 million and it used the dominance to give insurance companies preferential treatment even if it meant fewer choices and higher prices for patients. it doesn't admit wrongdoing, but it agrees to drop the insurance clauses and the fed agreed to drop the case. i spoke with josh stein about all of this, i'm looking into the real cost benefit to you and whether you could see health care costs drop and more choices soon. i'm working to get you those answers starting at eyewitness news at 5:00.
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Nov 15, 2018 | Charlotte, NC
By WBT (Radio)
Audio Link: https://app.criticalmention.com/app/#clip/view/457956e6-e083-4167-aa3d-b0d78ad5f29b?token=50743fe7-d6ce-4a1f-8f67-f1632bb8c935
Rough Transcript: “Carolina's biggest health care fighter atrium health strikes a deal with the federal government to change the way does business details from w. b. t.'s mark garrison both the state and federal governments accused atrium of engaging in illegal tactics with insurance companies the fed say the tactics drove up the price of our health care specifically atrium forced insurance companies not to tell patients they could get certain procedures done more cheaply at no bond and other hospitals or we believe that consumers get better quality and lower costs planned there's more competition adroit cooper explaining the lawsuit that was filed two years ago that suit has now been settled adrienne has agreed to let insurance companies send patients anywhere a trail will not pay a fine and the hospital chain has admitted no wrongdoing.”
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Nov 15, 2018 | Charlotte, NC
By WFAE (NPR)
Audio Link: https://app.criticalmention.com/app/#clip/view/03ff476b-423a-4af7-8ffc-0150d00cbb1e?token=50743fe7-d6ce-4a1f-8f67-f1632bb8c935
Rough Transcript: Atrium health and the north carolina and federal justice departments have settled an antitrust lawsuit about health care pricing the suit up more than two years ago claimed interim head agreements with ensures that prevented them from incentivize in patients to get cheaper care at competitors in the charlotte market in terms it's not admit any wrongdoing in the settlement and is not required to pay any penalties are finds the ripples agreement will prohibit atrium from drawing up contracts been sharon's companies that prevent insurers for sharing price details with patients or force insurers have a truce approval before introducing or offering patient incentives to use cheaper hospitals or doctors among other things the settlement is still waiting for final approval from a judge
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Nov 15, 2018 | WUNCFM (Radio)
By Raleigh, NC
Audio Link: https://app.criticalmention.com/app/#clip/view/4b87dedc-ec10-40d7-a534-a839dd4ba3cc?token=50743fe7-d6ce-4a1f-8f67-f1632bb8c935
Rough Transcript: attorney general josh steiner announced today he's reached a settlement with atrium health it's the result of an anti trust lawsuit the north carolina department justice filed two years ago settlement prohibits atrium health from signing contracts with insurers that would prevent the disclosure of health care prices to consumers a tree was not found to be violating any law and will pay no penalty or fines
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Nov 15, 2018 | WFDD - NPR
By Winston-Salem / Greensboro, NC
Audio Link: https://app.criticalmention.com/app/#clip/view/bec74914-be5b-47b4-9502-a31dd81d76d5?token=50743fe7-d6ce-4a1f-8f67-f1632bb8c935
Rough Transcript: federal prosecutors say a dominant north carolina hospital system has agreed to halt insurance practices they hindered patients from finding better health care deals the u. s. doug justice department said today that atrium health agreed to a settlement that prohibits the charlotte based system from including certain anti competitive measures in its contracts with health insurers federal prosecutors say the contract restrictions had kept insurers from encouraging patients to find the most cost effective hospitals and doctors the federal anti trust lawsuit founded two thousand sixteen argued that the hospital chain also operate in south carolina formerly known as carolina's health care system but it used its market power to keep consumers from exploring options that offer them the best value
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