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A self-insured pharmacy sued Advocate Aurora Health on Tuesday for allegedly using all-or-nothing contracts to force Wisconsin employers to pay inflated prices rather than steer patients to lower-cost hospitals outside the health system.
Advocate Aurora allegedly charges more than its competitors for routine services like a colonoscopy with a biopsy, which cost $10,700 at Advocate Aurora compared to $4,700 at Froedtert & the Medical College of Wisconsin, according to the lawsuit filed Tuesday in a Wisconsin federal court by Uriel Pharmacy, which offers a self-funded health plan for its employees in East Troy, Wisconsin. The not-for-profit health system operates 27 hospitals in Illinois and Wisconsin.
The plaintiff seeks to represent a class for all businesses, unions and local governments with a self-funded health plan who paid for services from Advocate Aurora in Wisconsin in the last six years. The pharmacy also requested an injunction preventing anticompetitive behavior and damages.
“(Advocate Aurora Health) has gone to extraordinary lengths to suppress innovative insurance products, such as tiered plans, that would reduce costs for employers. And it has used a combination of acquisitions, referral restraints, non-competes and gag clauses to suppress competition from other healthcare providers and attempt to expand its monopoly over acute inpatient hospital services into other, separate markets,” the complaint said.
Advocate Aurora is reviewing the lawsuit and did not immediately comment.
The lawsuit comes on the heels of Advocate Aurora’s announcement to join forces with Atrium Health, a 40-hospital system based in Charlotte, N.C. The combined organization would have 67 hospitals, an estimated $27 billion in revenue and nearly 150,000 employees across Illinois, Wisconsin, North Carolina, South Carolina, Georgia and Alabama.
Advocate Health Care and Aurora Health Care merged in 2018, and the organization has since looked for merger partners outside of Illinois and Wisconsin.
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