On Wednesday, Buncombe County and the City of Asheville, North Carolina filed a complaint in the Western District of North Carolina against HCA Healthcare, Inc., MH Mission Hospital and affiliated companies for an alleged scheme to monopolize healthcare in two regions of western North Carolina.
Buncombe and Asheville operate self-funded health insurance plans for their employees and seek to represent other North Carolina insurance plans with this case. For these insurance plans, the plaintiffs “paid directly to one or more Defendant(s) on behalf of their insureds for health care services in the relevant markets alleged herein.” They claimed that the defendants have monopolized the hospital inpatient general acute care (GAC) and outpatient care markets in the region, which consists of six counties in the state.
The plaintiffs estimated that Mission and HCA control over 85% of the GAC market in the region. They accomplished this by allegedly buying out the only other significant competitor while antitrust regulations were minimal, allowing Mission to become an “unregulated organization with monopoly power.”
Due to the monopolization of the market, the defendants have been able to “raise prices substantially above competitive levels, to reduce health care choices, to reduce quality through dramatically worsened facility conditions and patient service” and limit access to their services. Furthermore, their healthcare prices are “the highest in North Carolina” since the defendants “have the ability to impose anticompetitive contract terms” due to their prominence in the region. They also allegedly imposed “gag clauses” in contracts with insurers to obscure their price increases, which has harmed the plaintiffs and their employees.
The plaintiffs are seeking class certification, a declaration that the defendants have violated Sections 1 and 2 of the Sherman Act, treble damages, injunctive and declaratory relief, attorney’s fees and costs, and other relief.