DOJ's proposed OhioHealth judgment voids the contract clauses that block steering to ASCs
A proposed final judgment filed in the Southern District of Ohio would wipe out OhioHealth's anti-steering and transparency restrictions and install a five-year monitor; the government's competitive impact statement names the ambulatory surgery center as the lower-cost site payers were kept from steering to.
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The Justice Department and the State of Ohio have moved to void the contract terms that keep commercial surgical volume inside OhioHealth’s hospitals — restrictions the government says stop payers accounting for “at least 85% of commercial health insurance business in the Columbus area” from introducing budget-conscious plans.
The proposed final judgment and competitive impact statement published in the Federal Register on July 23 resolve United States, et al. v. OhioHealth Corporation, Case No. 2:26-cv-207 in the U.S. District Court for the Southern District of Ohio, Eastern Division, with Ohio as co-plaintiff. The complaint was filed February 20, 2026; the parties filed the proposed judgment on June 16. It is not yet entered — under the Tunney Act, public comment “is invited within 60 days of the date of this notice,” which puts the deadline at September 21.
What makes it an ASC document is the theory of harm. The competitive impact statement defines the practice at issue in terms surgery-center operators will recognize: “Site of service steering is a plan feature that saves money by incentivizing patients to have procedures done in a lower-cost site of service — such as an ambulatory surgery center — instead of a higher cost site of service, such as a hospital.”
The remedy is conduct, not divestiture, and it is broad. Paragraph IV.A of the proposed judgment makes void “any and all of Defendant’s contract provisions that prohibit, deter, prevent, or Penalize Steering, Steered Plans, or Transparency.” Paragraph IV.B bars OhioHealth from seeking terms requiring prior approval before a payer introduces a new benefit plan, or guaranteeing the system a spot in the most-preferred tier. Paragraph IV.C bars penalizing a payer for providing price transparency or for designing, offering, expanding, or marketing a steered plan. The definition is deliberately wide: “Steering” means “a Payor providing any incentive to that Payor’s members to seek care at specific Providers or types of Providers” — types of providers being the operative phrase for a center competing against an HOPD.
A court-appointed monitor serves a five-year term at OhioHealth’s expense. The judgment itself “will expire ten (10) years from the date of its entry.”
Scale explains the government’s interest. OhioHealth “owns or manages 16 hospitals in Ohio and is attempting to acquire Fairfield Medical Center in Fairfield County, Ohio,” and the filing calls it “the dominant hospital system in the Columbus area,” with more than 35% of inpatient general acute care discharges in 2023 in both the Central Columbus and Columbus MSA markets. Three systems together “control more than 85% of inpatient GAC discharges” in the broader MSA.
For operators, the practical read is that the steering commercial payers have been building into policy can be made unusable by supply-side contract language. This filing says what a dominant system may not do about that.