ALBANY, N.Y. (NEXSTAR) — The U.S. Department of Justice sued the New York and Presbyterian Hospital on Thursday for allegedly using its size and influence to force health insurance companies into restrictive contracts. According to the federal antitrust lawsuit—which you can read at the bottom of this story—NYP prevents insurers from offering affordable health plans, illegally driving up medical costs for the average New Yorker.
As tallied in the federal complaint, NYP operates eight acute care hospitals downstate, including six in New York City, and controls more than 30% of patient discharges in Manhattan. The nonprofit network fills over two million appointments with patients every year, employing over 10,000 affiliated physicians and another 50,000 workers. It’s also the primary teaching hospital for the medical schools Weill Cornell Medicine and Columbia University’s Vagelos College of Physicians and Surgeons.
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The government said that this market share forces insurers into NYP contracts, since it’s impossible to do business in New York City and avoid the NYP network. Most New Yorkers rely on their employer or insurance provider to negotiate medical prices and according to the DOJ, they try to save patients money by lowering copays at less expensive, high-quality doctors’ offices and clinics.
But the federal government claimed that NYP forces insurers to place NYP facilities in the most favorable benefit categories despite having higher prices. That blocks providers from creating budget-friendly plans that would encourage visits to cheaper rivals like Mount Sinai, NYU Langone, or Northwell, and according to the lawsuit, the lack of competition means New Yorkers pay higher premiums and out-of-pocket fees. According to internal hospital documents cited in the lawsuit, NYP calculated that allowing budget-conscious, tiered insurance plans into the market would reduce its profits by hundreds of millions…