The DOJ Just Sued OhioHealth Over the Same Problem Dental DSOs Face Every Day
The Department of Justice filed an antitrust lawsuit against OhioHealth last week — the largest health system in central Ohio — for using its market power to impose contract terms that suppress competition and lock patients into higher-cost care.
The core allegation: OhioHealth forces insurers to include it in every commercial network they offer, regardless of price. You can't build a budget-tier plan that routes patients to lower-cost alternatives. You can't show patients a cost comparison. You can't compete on price. The contract prevents it.
"OhioHealth generally forces insurers to include OhioHealth in all of the networks for the commercial insurance products they offer, regardless of how OhioHealth's prices compare to its competitors."
The DOJ calls this anticompetitive. And technically, in this context, it is — because OhioHealth is using it to block patients from choosing lower-cost providers.
But this exact structure — mandatory inclusion, opaque contract terms, no price transparency — isn't unique to hospital systems. It's the operating model of every major dental PPO leased network in the country. The direction is just reversed.
Dental DSOs live this from the other side
When you sign a PPO participation agreement, the plan gets to decide which other networks can access your contracted rates. That clause — buried in the fine print under "third-party access" or "network leasing" — is what allows your Humana contract to reprice through Zelis at a lower fee schedule than you negotiated.
You didn't agree to Zelis rates. You agreed to Humana rates. But the contract you signed gave Humana the right to lease your participation to Zelis without your explicit knowledge or renegotiation.
In OhioHealth's case, the hospital used contract power to force inclusion. In the DSO case, the plan uses contract power to force repricing. Different direction — same information asymmetry. One party knows exactly what the contract says and how to use it. The other doesn't.
The information asymmetry is the whole game
The DOJ's complaint is notable not just for what it targets — but for what it says about how network contracts actually work. Healthcare contracting has always been designed to limit what the other party can see and compare. Mandatory all-product clauses. Leasing provisions. Gag clauses on price disclosure. Most-favored-nation restrictions.
These aren't bugs. They're features — features that benefit whoever drafted the contract.
For hospital systems, that power flows toward the health system. For dental providers, that power flows toward the plan. In both cases, the entity without visibility into the network structure pays a financial penalty that doesn't show up as a line item — it shows up as a write-off, a lower reimbursement, a plan your patient has that you didn't know would reprice at a different rate.
What this means for DSOs watching this case
The OhioHealth lawsuit is a signal that the DOJ is paying attention to network contract practices that distort competition. That scrutiny is unlikely to stay confined to hospitals.
The dental PPO leasing market — where a single plan can route your participation to dozens of sub-networks through a chain of leasing agreements you were never shown — operates with the same opacity the DOJ is now challenging in Ohio.
Knowing your network routing isn't just operational hygiene anymore. It's an asset — because the information gap between what plans know about your contract and what you know is where the revenue leakage lives.
See who's actually repricing your claims
PayorMap maps every major dental PPO leasing relationship so DSOs can see which plans route through which networks — and what fee schedule actually applies.
Start Free Trial →Source: U.S. Department of Justice, Antitrust Division — February 2026