Attorney General James Sues UnitedHealth and Amedisys to Stop Merger That Threatens Senior Care Nationwide

November 12, 2024

NEW YORK - New York Attorney General Letitia James today joined three attorneys general and the U.S. Department of Justice (DOJ) in suing UnitedHealth Group (United) and Amedisys, Inc. (Amedisys), two of the nation's largest providers of home health and hospice services for seniors, to block United's acquisition of Amedisys that could threaten the quality of critical health care services for millions of seniors. United and Amedisys are each other's top competitors in many home health markets across the country, including in certain areas in upstate New York. The competition forces both companies to improve the quality of their services and keep costs low, and also incentivizes them to offer higher pay and benefits to attract workers. As the lawsuit alleges, United's acquisition of Amedisys would violate antitrust laws by eliminating this competition, leaving vulnerable patients and their families with worse care and higher prices, and result in lower pay and benefits for the nurses who provide these critical services.

"Quality home health and hospice services provide essential care to seniors where they are most comfortable - in their homes, surrounded by their family and loved ones," said Attorney General James. "Competition among health care providers helps ensure both patients and the workers who care for them are treated fairly and with dignity. United's acquisition of Amedisys would limit how seniors can get care, allowing United to raise prices and cut corners without fear of losing customers. I have always stepped up to stop harmful mergers that hurt consumers and workers, and I will continue to take action to protect vulnerable seniors and the thousands of workers who care for them."

Millions of seniors across New York and the country rely on home health and hospice services to stay in their homes as they receive essential medical and end-of-life care. Home health workers provide skilled nursing and therapy services for seniors managing chronic conditions like heart failure, Alzheimer's, and dementia. Hospice workers provide critical end-of-life care that allows patients to live out their final days comfortably and provide social services, counseling, and other assistance to patients' families. As demand for home health and hospice rises as the U.S. population ages, these services are becoming increasingly valuable and essential for millions of American families.

Recent acquisitions and mergers of health care providers have reduced the number of competing providers and led to the formation of a handful of powerful nationwide companies, including United and Amedisys. United, one of the largest companies in the nation, is ubiquitous in the health care sector. United is not only the largest provider of commercial health insurance in the nation, but through its subsidiaries it is also the largest single employer of physicians. United provides numerous primary and specialty care services, is one of the largest pharmacy benefits managers in the nation, and is one of the largest health care technology and service vendors.

Competitive markets for home health and hospice services are crucial for ensuring patients receive quality care. Both United and Amedisys recognize this dynamic. As the lawsuit illustrates, United and Amedisys take active steps to improve the quality of their services and reduce their prices to attract customers. For example, both United and Amedisys have invested heavily in developing programs aimed at managing specific conditions, such as heart failure or respiratory diseases, in order to attract more patients. The loss of Amedisys as a competitor removes a significant constraint on United's ability to increase prices or reduce its offerings, including in New York facilities.

The competition between United and Amedisys also benefits the thousands of nurses who work in home health or hospice care. The two companies compete to offer better pay and benefits to attract top talent. As alleged in the lawsuit, both United and Amedisys offer their employees sizeable bonuses to keep them from leaving for a competitor and tailor their benefits packages - including health insurance, disability insurance, paid leave, and 401(k) matches - to outdo each other. As the lawsuit argues, allowing United to acquire Amedisys would severely reduce this competition for labor and the need to provide quality pay and benefits.

With this lawsuit, Attorney General James, DOJ, and the coalition of attorneys general seek a court order blocking the merger of United and Amedisys, as well as $13 million in civil penalties for Amedisys' failure to comply with records requests as part of seeking approval for the merger.

Joining Attorney General James and DOJ in the lawsuit are the attorneys general of Illinois, Maryland, and New Jersey.

Attorney General James has consistently taken action to protect New Yorkers from unfair anticompetitive tactics. In August 2024, a bipartisan coalition of attorneys general led by Attorney General James won a major court victory in their case against Google after the U.S. District Court for the District of Columbia found that Google has maintained an illegal monopoly of online search engines. Attorney General James has joined bipartisan coalitions of attorneys general to sue the NCAA for imposing unfair restrictions on student athletes' careers in May 2024 and December 2023. Also in December 2023, Attorney General James and a bipartisan coalition of attorneys general announced a $700 million settlement with Google as a result of their lawsuit for Google's monopolistic conduct in its app store that increased costs for consumers and app developers. In September 2023, Attorney General James, the Federal Trade Commission (FTC), and a bipartisan coalition of Attorneys General sued Amazon for maintaining illegal monopoly power that hurts consumers and businesses. Attorney General James has also ended the use of no-poach agreements that limit competition for employees by the five largest insurance companies in the United States, including First American, Fidelity, Old Republic, Stewart, and Amtrust.

This matter was led for New York by Assistant Attorney General Saami Zain of the Antitrust Bureau, under the supervision of Amy McFarlane, Deputy Bureau Chief, and Elinor Hoffmann, Bureau Chief. The Antitrust Bureau is part of the Economic Justice Division, led by Executive Deputy Attorney General for Economic Justice Chris D'Angelo and overseen by First Deputy Attorney General Jennifer Levy.