UNITED STATES OF AMERICA and THE STATE OF NORTH CAROLINA, Plaintiffs, v. THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY d/b/a CAROLINAS HEALTHCARE SYSTEM, Defendant.

This case involves the relationship between hospital system and insurance company, and how that relationship affects everyday patients and consumers……..

BACKGROUND

For most, the world of healthcare is a perplexing one sought to be avoided, but frequently necessary. Health insurance only adds complexity, including factors such as co-pays, deductibles, in-network providers, and out-of-network providers. And while these complexities may have benefits, they also present difficulties, frequently to consumers who become limited by who can provide their healthcare and how much it will cost.

This case involves the relationship between hospital system and insurance company, and how that relationship affects everyday patients and consumers. At its core, this case asks whether a hospital system’s contractual restrictions on insurance companies operate as an unreasonable restraint on trade, specifically, can a hospital authority’s contract with insurance companies include “steering” restrictions that limit insurance companies’ ability to inform their customers about, or incentivize them to use, other health-service providers which may be able to provide better or more affordable service.

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