The Sisters of Charity, who once owned Columbia’s former Providence Hospital, have sued Columbia’s Palmetto Health hospital system, alleging the health giant stole Providence’s valuable orthopedic practice worth $50 million.

The Sisters of Charity seek not only $50 million, but also punitive and other damages for the loss of Moore Orthopedic Clinic – additional damages that could wind up costing Palmetto Health hundreds of millions of dollars, were it to lose the lawsuit.

The lawsuit pits two iconic Columbia hospitals – Palmetto and Providence – against each other in what will be a high-stakes legal battle where not only money, but prestige and reputations, are on the line. There are few people in the Columbia area who have not received medical treatment at either hospital complex or who don’t see doctors affiliated with those hospitals.

Palmetto Health spokeswoman Tammie Epps said Thursday evening she was unaware of Providence’s lawsuit and would likely respond to it Friday.

The lawsuit was made public late Thursday afternoon on a federal court records data base. The Sisters of Charity seek a jury trial; U.S. Judge Terry Wooten is hearing the case.

The suit was brought by Sisters of Charity Providence Hospitals Legacy Corp., a legal entity of the Catholic charity that ran Providence since 1938 and established a foundation that has given, and continues to give, millions of dollars annually to various groups around the Midlands and South Carolina.

No matter who wins, the lawsuit promises a rare public examination of the big money finances and inner dealings of hospitals in the Columbia area health care business, with its thousands of doctors and nurses, and billions of dollars in annual billings and insurance claims. The lawsuit focuses on major trends in health care – hospital mergers and the increasing acquisition of profitable specialty doctors’ practices by hospitals.

Evidence in the case includes once-secret emails and text messages by former Providence doctors and top officials who allegedly conspired with Palmetto Health to wrest the money-making Moore Clinic doctors away as Providence was being sold, the lawsuit said.

“This case promises to show people the reason health care costs are going up,” said Lynn Bailey, a Columbia health care economist. “Modern health care is not about providing affordable health care to patients – it is about making money off of sick people.”

The lawsuit alleges that Palmetto Health already has “monopoly power” in the Columbia area and that when, beginning in 2014, Palmetto Health “secretly and illegally conspired” to take from Providence its profitable orthopedic surgery business, it did so to “weaken Providence’s ability to compete with Palmetto Health.”

Orthopedics is a highly profitable medical specialty dealing with bones, joints and tendons.

Despite Palmetto’s monopoly strength, Providence Hospital was able to compete with it in orthopedic surgery “because Providence had spent tens of millions of dollars beginning in 2010 to build and develop the orthopedic surgery business line of its Moore Clinic … These investments exceeded $30 million,” the lawsuit said.

In 2011, at the urging of Moore Clinic surgeons, Providence abandoned its obstetrics line of business at Providence Northeast and “at great expense converted the area that had been devoted to obstetrics (pregnancy and baby delivery) to orthopedic surgery,” the lawsuit says.

By 2014, orthopedics was Providence’s “most profitable line of business … and was critical to Providence’s long term survival,” the lawsuit said. Almost 90 percent of Providence’s orthopedic surgeries were performed by Moore Clinic physicians, the lawsuit said.

In late 2013, Providence – seeking more financial and operational resources – began to discuss affiliations with other hospital systems, including Palmetto Health, the lawsuit said.

In these discussions, Palmetto Health “became aware of Providence’s financial challenges and that Providence’s chief profitable service line was its orthopedic services,” the lawsuit said.

Newly aware of how profitable the Moore Clinic orthopedics arm of Providence was, Palmetto Health decided “to attempt secretly to acquire Providence’s orthopedic surgery business,” the lawsuit said.

In late April, the Moore Clinic notified Providence its doctors and staff were quitting to join Palmetto Health – an action that damaged Providence in its last-minute negotiations with LifePoint, its eventual buyer, the lawsuit said.

The lawsuit also alleges numerous violations of various federal laws prohibiting monopolistic business practices activities that stifle competition and hurt consumers. It also alleges some former Providence officials owed Providence a “duty of loyalty” and wrongly gave Palmetto Health confidential information.

Michael Kapp, chairman of the board of the Sisters of Charity Providence Hospital Legacy Group said late Thursday any money recovered will go to the Sisters of Charity Foundation and go to help low-income South Carolinians.