DOJ Sues NYP for Sherman Act Antitrust Violations
Summary
The DOJ and U.S. Attorney's Office for the Southern District of New York filed a civil antitrust lawsuit against New York-Presbyterian Hospital (NYP), alleging Section 1 Sherman Act violations through anti-competitive contract provisions with commercial payors. The government seeks injunctive relief and a declaratory judgment that NYP's contract restrictions violate antitrust law.
What changed
The DOJ filed a 21-page complaint alleging that NYP, the dominant hospital system in New York City, violated Section 1 of the Sherman Act by requiring restrictive anti-competitive language in its commercial contracts with health insurance companies. Specifically, NYP allegedly forced payors to include all NYP hospitals and providers in their networks (all-or-nothing provisions) and restricted payors from offering innovative budget-based insurance products. The complaint seeks to enjoin NYP from these practices and have the court declare the contractual restrictions unlawful.
Healthcare providers and hospital systems should review their existing commercial payor contracts for similar all-or-nothing network inclusion clauses and restrictions on budget-conscious insurance products. NYP must respond to this litigation and face potential injunctive relief if found in violation. Other providers should assess whether their market position could attract similar scrutiny under antitrust laws.
What to do next
- Review commercial payor contracts for all-or-nothing network inclusion clauses
- Audit contracts for provisions restricting budget-based or narrow-network insurance products
- Monitor this litigation as it may establish precedent for hospital payor contracting practices
Penalties
The complaint seeks injunctive relief and a declaratory judgment that NYP's contract restrictions violate Section 1 of the Sherman Act.
Source document (simplified)
April 1, 2026
DOJ Sues NYP
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On March 26, the U.S. Department of Justice (DOJ) and the U.S. Attorney’s Office for the Southern District of New York filed a civil antitrust lawsuit against The New York and Presbyterian Hospital (NYP). The Complaint alleges that NYP violated Section 1 of the Sherman Act by requiring restrictive anti-competitive language in its commercial contracts with health insurance companies (payors). The government contends that such actions have resulted in increased costs to the healthcare system and eliminated competition.
The government emphasized that NYP is the dominant and most powerful hospital system in New York City and has used that dominance to maintain its high pricing. The Complaint alleges that due to NYP’s market dominance, it can charge considerably higher rates than two reputable competing hospital systems – NYU Langone and Mount Sinai. Each competitor includes an academic medical system where the quality of care is comparable to that offered by NYP. NYP’s two main hospitals, New York-Presbyterian/Columbia University Irving Medical Center and New York-Presbyterian/Weill Cornell Medical Center, are in Manhattan, and NYP’s other six hospitals are located throughout New York City.
The government claims that NYP used this dominance to force upon payors anti-competitive contractual provisions. One such provision requires payors to include all of NYP’s hospitals and providers in a payor’s commercial network, or have none of them. Payors are forced to accept this as they cannot exclude NYP. The government further alleges that NYP restricts payors from offering other innovative budget-based insurance products that provide patient choice among care providers with more competitive rates. Such products could include narrow networks in which care providers may be willing to reduce their rates in exchange for greater patient volume.
The 21-page Complaint seeks to enjoin NYP from continuing such practices, and to have the U.S. District Court adjudge that all restrictions on budget-conscious commercial plans in the contracts between NYP and commercial payors violate Section 1 of the Sherman Act. As a result of this newly filed litigation, other providers and systems will likely review their existing contracts for similar offending language and restrictions.
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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.
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Rivkin Radler LLP
2026
Written by:
Rivkin Radler LLP Contact + Follow Christopher Kutner + Follow
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