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Judge halts ProMedica’s efforts to terminate insurance contracts – Health News Today


A federal judge Tuesday issued a preliminary injunction preventing ProMedica’s insurance subsidiary from terminating contracts with competing providers.

U.S. District Judge Jack Zouhary found that the plaintiffs, McLaren St. Luke’s and WellCare Physicians Group, provided evidence to support their argument that Toledo, Ohio-based ProMedica built up enough market power to support “at least an attempted monopolization claim.”

ProMedica’s insurance subsidiary Paramount in mid-November sought to terminate its commercial insurance and Medicare Advantage contracts with St. Luke’s and its physicians, effective Jan. 1. Paramount sent the termination notice one day after McLaren Health Care Corp. acquired St. Luke’s Hospital.

McLearen and WellCare sued, claiming ProMedica’s action was part of “a scheme of monopolization or attempted monopolization,” the court ruling said, and that it would limit access to care. Zouhary agreed, citing evidence from McLaren stating that ProMedica has a 56% market share.

“There is little doubt that ProMedica’s conduct was exclusionary,” he wrote.

In an emailed statement, ProMedica said it disagreed with the ruling and planned to file an appeal to the U.S. Court of Appeals for the Sixth Circuit.

“In the interim, ProMedica intends to comply with the court’s order,” the statement said. “We are currently in the process of informing all affected health insurance members and remain committed to helping our members access the highest quality of care to improve their health and well-being.”

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