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CHARLOTTE, N.C. – The Justice Department announced Thursday morning that it has reached an agreement with Atrium Health (formerly known as the Carolinas HealthCare System) as a result of a lawsuit against the competition.
It all began in 2016 when the US Department of Justice, along with the North Carolina Department of Justice, sued Carolinas Healthcare System, which is now called Atrium Health.
The regulation prohibits Atrium from using anti-competitive restrictions in contracts between health insurance companies and service providers in the Charlotte area.
Atrium Health officials said that the settlement agreement did not provide for any wrongdoing and that Atrium Health had not broken the law. In addition, Atrium Health will not pay any penalty or fine.
Channel 9 investigative reporter Jason Stoogenke spoke exclusively with Attorney General Josh Stein about the settlement and looks at the real cost benefits to you. pm
If it is approved by the court, the settlement will resolve more than two years of civil antitrust litigation involving Atrium's driving restrictions, which prevent health insurers from promoting innovative social benefit plans and more economical health services for consumers.
[ALSO READ: Atrium Health, Novant compete to expand services in Mecklenburg County]
"Faced with rising health care costs, vigilant antitrust enforcement is an essential tool for consumer protection," said Deputy Attorney General Makan Delrahim. "By removing the restrictions that limit comparator purchases and interfere with competition among healthcare providers, the current resolution of our antitrust action allows consumers in the Charlotte area to reap the benefits of competition when health choices of crucial importance.
In June 2016, the Ministry of Justice launched a civil antitrust action against Atrium to challenge provisions prohibiting the management of hospital system contracts with major health insurers.
[ALSO READ: Court order allows Atrium Health to bring on new anesthesia provider]
Pilotage is a method used by insurers to provide consumers with the opportunity to reduce some of their health care expenses. As the complaint claims, insurers are increasingly developing health insurance plans that offer patients financial incentives to choose more cost-effective hospitals and doctors.
Increased consumer access to these health insurance plans stimulates competition among providers to offer lower premiums and better health services.
The Department of Justice alleged that Atrium had used its market power to prevent health insurance companies from encouraging consumers to choose health care providers offering better overall value. The restrictions also prevented insurers from providing consumers and employers with information on the cost and quality of alternative health protection schemes.
[ALSO READ: Doctors finalizing plans to leave Atrium Health]
"Competition encourages health care providers to reduce costs, lower prices and improve quality," said Delrahim. "Restrictions of the Atrium management have interfered with the competitive process, resulting in fewer choices and higher costs for consumers."
Atrium Health leaders have always championed patient choice and believe that the quality, value and services provided by Atrium are why more people continue to choose them, to the detriment of other providers. of health care in the area.
"The resolution of this antitrust action gives consumers in the Charlotte area what they did not have before: the ability to receive the appropriate and high quality treatment they need, at a fair price, of a health care provider of their choice, "said the US attorney. for the western district of North Carolina, R. Andrew Murray. "Today's enforcement measures will restore competition in the Charlotte region, which will result in lower health care costs and better access to health care for consumers and their families."
The proposed regulation also prevents Atrium from soliciting contractual clauses or taking any measures prohibiting, preventing or penalizing the insurers' management in the future.
Atrium is North Carolina's largest health system and one of the largest nonprofit health systems in the United States. The flagship medical center of Atrium is the Carolinas Medical Center, the largest hospital in North Carolina.
Atrium also operates eight other general acute care hospitals in the Charlotte area and owns, manages or has strategic links with more than 40 hospitals in the Carolinas.
In 2017, Atrium's hospitals and other health care providers owned, managed and affiliated generated net revenues of nearly $ 10 billion.
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