HCA Healthcare is accused of engaging in anti-competitive behavior in a company New class action Submitted on Tuesday.
Hospital operator in Nashville, Tennessee Purchase Mission Health in 2019 According to a lawsuit filed by six state residents, they hope to obtain monopoly control in western North Carolina.
Mission Health is a six-hospital system located in Asheville, North Carolina, which is said to have been in a monopoly from 1995 to 2019. “The plaintiff made a claim.
Since the completion of the purchase, HCA has used improper restrictions in its arrangements with third-party managers of commercial health plans and self-insurance plans, “including tying, all-or-nothing arrangements, gag clauses and… other anti-competitive clauses. And negotiated according to the lawsuit, the equipment “to push up prices.”
The document cited data from the RAND Corporation in 2020, showing that the defendant charged commercial insurance companies for hospitalization and outpatient services on average 372% higher than the medical insurance price, and the medical insurance price for hospitalization services alone was 393% higher on average. This is much higher than the average of 262% and the median of 277% of medical insurance prices charged by other hospitals in North Carolina in the RAND study.
It is said that in addition to raising prices, HCA has been cutting costs and laying off staff, resulting in a decline in the quality of health care in Mission Health service areas.
“Today, HCA has approximately 90% of the market…for inpatients [general acute] Hospital care in Boncombe County, the most populous county in western North Carolina, and nearby Madison County,” the lawsuit states. “Because insurance companies and consumers in this area have no choice but to use HCA, HCA is free to control The price charged to insurance companies and consumers, while reducing costs by reducing quality. “
In addition, HCA refuses to fully comply Hospital price transparency rules The lawsuit claims that the lawsuit was promulgated at the beginning of the year.
The plaintiff is seeking damages and injunctions and declaratory relief to prevent HCA from engaging in anti-competitiveness in the future. They are also seeking a jury trial.
In a statement provided to MedCity News, HCA confirmed its commitment to the people of Western North Carolina.
Mission Health/HCA Healthcare NC department spokesperson Nancy Lindell said in an email: “Once we receive a lawsuit, we will respond appropriately through legal procedures.” We are committed to taking care of Western North Carolina. Now we have provided more than $330 million in charitable care and uninsured discounts and hospital services in 2020… In addition, we have invested in colleagues and added nearly 1,200 new members this year.”
The lawsuit happened about a month after President Joe Biden Issue administrative orders Target anti-competitive behavior, including in the context of hospital integration. Biden urged the Department of Justice and the Federal Trade Commission to review and revise their combined guidelines from the perspective of preventing patient harm.
But how government agencies will act in accordance with executive orders remains to be seen.
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