US DOJ Antitrust Official Outlines Aggressive Healthcare Competition Crackdown in Major Policy Speech

A senior official from the U.S. Department of Justice has announced a renewed and expanded focus on healthcare competition enforcement, highlighting hospital systems, pharmaceutical supply chains, and pharmacy benefit managers as key priorities.

Deputy Assistant Attorney General Nicole Sarrine delivered remarks at the Transparency Rising 2026 National Forum in New Orleans, where she detailed ongoing investigations and legal actions aimed at reducing healthcare costs and increasing market competition.

Healthcare at the Center of Antitrust Strategy

Sarrine said the Antitrust Division is prioritizing cases that directly affect the cost of living for American households, particularly rising healthcare and insurance expenses.

She emphasized that healthcare markets are increasingly shaped by:

• Limited price transparency
• Vertical integration among insurers and providers
• Market concentration in key sectors
• Complex incentives involving employers, insurers, and patients

According to the remarks, these structural factors can reduce competition and lead to higher costs for patients and taxpayers.

Hospital Systems Targeted for Contracting Practices

The speech referenced ongoing antitrust cases against major hospital networks, including alleged restrictive contracting practices that limit competition among insurers and healthcare providers.

The DOJ is currently pursuing enforcement actions involving hospital systems such as:

• OhioHealth
• NewYork-Presbyterian

The agency alleges that certain contracting rules restrict insurers from steering patients toward lower-cost care options, potentially inflating healthcare costs.

Major Merger Challenge and Divestiture Deal

Sarrine also highlighted a recent enforcement victory involving the healthcare sector.

The DOJ secured a settlement requiring divestitures following concerns over UnitedHealth Group’s acquisition of Amedisys, a major home health and hospice provider. The remedy included the largest outpatient healthcare divestiture ever required by the Antitrust Division.

The official said such cases are part of a broader effort to prevent excessive consolidation in healthcare markets.

Pharmacy Benefit Managers Under Scrutiny

A significant portion of the speech focused on pharmacy benefit managers (PBMs), companies that manage prescription drug benefits and negotiate pricing between insurers, pharmacies, and manufacturers.

Sarrine noted concerns around:

• Industry concentration
• Vertical integration with insurers
• Lack of pricing transparency
• Potential conflicts of interest

While she did not announce new enforcement actions, she confirmed that PBMs remain under active review.

Regulatory Environment and Federal Policy Alignment

The remarks also referenced broader federal policy changes aimed at lowering drug prices and increasing transparency in the pharmaceutical supply chain.

These include:

• Executive actions promoting prescription drug price reform
• New transparency requirements for healthcare intermediaries
• Ongoing reforms to PBM reporting obligations
• Labor Department proposals on fee disclosure rules

The DOJ said it is monitoring how these developments may affect competition in healthcare markets.

DOJ Encourages Industry Cooperation

Sarrine stressed that the Antitrust Division relies heavily on cooperation from industry participants and whistleblowers to identify anticompetitive behavior.

She encouraged stakeholders to submit complaints and information through official channels, including the government’s healthcare competition reporting system.

“Affordability” Framed as Enforcement Priority

The speech repeatedly framed antitrust enforcement as a tool for addressing affordability concerns in essential sectors of the economy.

Sarrine concluded that while antitrust law is only one component of healthcare reform, it remains a central mechanism for ensuring competition and reducing costs for American consumers.

Courtesy: justice.gov