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HCA Healthcare faces lawsuit #3 in WNC, along with a letter from NC's AG


A joint class-action lawsuit filed by the City of Asheville and Buncombe County is the latest legal action against HCA Healthcare, the Nashville-based corporation that bought the nonprofit Mission Health System in 2019 . The lawsuit filed in federal court federal on July 27 is similar to the one filed in June by theCity of Brevard. It’s the third lawsuit against HCA in less than a year. The first was filed in August by a group of WNC residents in Buncombe County Superior Court.

According to a city-county news release the 59-page complaint details an extensive pattern of behavior by HCA intended to monopolize healthcare markets in western North Carolina, the result of which is artificially high prices for healthcare services and a reduced standard of care that has damaged, and continues to damage, local governments and private entities who act as self-insurers for their employees.

“This action was taken with careful consideration,” said Asheville Mayor Esther Manheimer said in the news release. “The Asheville City Council and the Buncombe County Board of Commissioners felt it was necessary to take this step to bring an end to predatory practices that limit HCA Healthcare’s competition and clearly result in overpriced and limited choices in people’s healthcare. We believe this lawsuit will not only address the damages sustained by local governments and other self-insured organizations, but will also result in a fair and improved healthcare system for our entire community.”

“The County Commissioners are concerned that HCA’s business operations monopolize healthcare while artificially inflating prices, and self-insured organizations like ours have no other recourse,” said Brownie Newman, chair of the Buncombe County Board of Commissioners. “On behalf of our public employees and our community, we have a responsibility to challenge these unfair business practices that harm patients and families at a time they are often most vulnerable.”

“Mission Health has been caring for Western North Carolina for more than 130 years and our dedication to providing excellent healthcare to our community will not waiver as we vigorously defend against this meritless litigation, We are disappointed in this action and we continue to be proud of the heroic work our team does daily. “ said Mission Health spokesperson Nancy Lindell in an emailed response to BPR.

Lindell’s statement highlighted the more than $270 million in charity care and uninsured discounts provided by HCA in 2021 along with the expansion of hospital services including the opening of the North Tower, a new Pediatric ER, and breaking ground on a new 120-bed behavioral health hospital.

“Further, we have invested in our community by contributing more than $2.5 million to community programs and paying more than $53 million in taxes just in 2021”, said Lindell. “Mission Health is committed to the health and well-being of every person who comes to us for care and we are proud of our dedicated hospital teams and the exceptional care they provide to our patients.”

A federal lawsuit filed in Juneby the City of Brevard outlines allegations – that HCA engaged in a scheme to monopolize health care markets in seven counties in western North Carolina: Buncombe, Macon, Madison, McDowell, Mitchell, Transylvania, and Yancey.

“Their predatory monopolistic practices are really hurting the ability of a community to get that affordable available and high-quality healthcare,” Brevard mayor Maureen Copelof told BPR shortly after the suit was filed.

The Asheville-Buncombe lawsuit was filed the same week North Carolina Attorney General Josh Steinsent a letterto the NC Department of Health and Human Services asking NCDHHS to deny Mission’s Certificate of Need application for 67 new acute care beds in Buncombe County. Advent Health and Novant Health have also submitted applications.

Stein’s letter mirrored the core allegations stated in the lawsuits:

“Currently, Mission has almost no competition for acute care in Buncombe County. The lack of competition is the result of Mission’s unique history. Mission effectively operated as a legislatively authorized monopoly for over twenty years, and no new hospitals have opened even after Mission’s arrangement with the State ended in 2016. This lack of competition harms residents of western North Carolina by increasing the cost, and reducing the quality, of health care services in the region. Awarding Mission this Certificate of Need would exacerbate the lack of competition and resulting harm. Accordingly, the Department should deny Mission’s application and instead approve an application from a qualified competitor.”

In an emailed statement, Mission Health Spokesperson Nancy Lindell responded:

“While we are not aligned with the opinion expressed in the AG Office’s letter, we are confident the NC Department of Health and Human Services will evaluate our application based on the state’s most recent Medical Facilities Plan, which detailed the need for 67 additional acute care beds. We are proud of our high-quality care and the significant investments we have made to expand access to healthcare, none of which were opposed by the AG’s office. Mission Health has responded to the growing medical needs of Western North Carolina by adding a new behavioral hospital, building a new wing and pediatric ER at Mission Hospital, constructing a new replacement hospital in Franklin and expanding capacity at Mission Hospital McDowell.”

A public hearing on the Certificate of Need applications is scheduled for Friday, August 12 at 9:30 a.m. in the Ferguson Building, Asheville-Buncombe Technical Community College.

Helen Chickering is a host and reporter on Blue Ridge Public Radio. She joined the station in November 2014.
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