Class-Action Suit Accuses Carolinas HealthCare of Anti-Competitive Behavior

Carolinas HealthCare Systems

A class-action lawsuit filed Sept. 9 against Carolinas HealthCare alleges the Charlotte, N.C.-based system engaged in illegal and anti-competitive behavior, according to The Charlotte Observer.

 

Christopher DiCesare, of Mecklenburg County, N.C., is the lead plaintiff in the case. The suit alleges Mr. DiCesare and other plaintiffs were forced to pay higher prices for insurance due to Carolinas HealthCare imposing steering restrictions in contracts with commercial health insurers.

Carolinas HealthCare purports to be a nonprofit but “in fact operates in its own interests leveraging market power to maximize revenues at the expense of its patients,” according to the suit.

The allegations made in the suit are similar to those included in an antitrust lawsuit filed by the Department of Justice and North Carolina Attorney General against Carolinas HealthCare in June.

That lawsuit alleges the system used its market power to require steering restrictions in its contracts with every major insurer in the area, including Blue Cross and Blue Shield of North Carolina, Aetna, Cigna and UnitedHealthcare. For example, the complaint states some of the contracts give Carolinas HealthCare the right to terminate their agreements if the insurers attempted to steer business from the system.

The steering provisions have prevented insurers from introducing health plans that encourage patients to use providers that offer lower price, higher quality services than Carolinas HealthCare, according to the DOJ.

Carolinas HealthCare has disputed the government’s allegations and asked the federal court to dismiss the complaint, according to the report.

Carolinas HealthCare hasn’t formally answered the class-action complaint. The system didn’t immediately respond to a request for comment on the pending litigation.

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