Faegre Drinker Secures Major Class Certification Victory in Long-Running Antitrust Litigation Involving the Mission Health System

On September 8, 2026, Faegre Drinker secured a major victory for client ANC Healthcare, the former nonprofit operator of the Mission Health System, by defeating class certification in long-running antitrust litigation involving the Asheville, North Carolina-based health system. The defendants also successfully excluded key portions of plaintiffs’ expert report offered in support of class certification. ANC is a co-defendant with HCA Healthcare, Inc., the current operator of the health system, which is represented by Simpson Thacher.

In his September 8 decision, Judge Mark A. Davis of the North Carolina Business Court declined to certify a proposed class of North Carolina residents and employers who paid premiums for health insurance plans through Blue Cross Blue Shield or United Healthcare.  The plaintiffs alleged that Mission Health engaged in anticompetitive tactics in violation of North Carolina antitrust law. Specifically, the putative class asserted that Mission Health used its claimed monopoly power to force insurers into unfavorable managed care contract provisions, resulting in increased prices for inpatient hospital services that were passed through to class members as higher insurance premiums, as well as diminished quality of care.

Judge Davis declined to certify the class because plaintiffs did not meet their burden of showing classwide impact for purposes of predominance as required for class certification under North Carolina law. In doing so, Judge Davis also excluded plaintiffs’ expert testimony as to alleged classwide impact because the analyses lacked a reliable econometric or statistical model that could support plaintiffs’ theory of harm.

This victory comes after years of discovery, a prior ruling in 2022 narrowing most of plaintiffs’ claims at the motion-to-dismiss stage, and the successful resolution of a separate but related federal antitrust action in 2025.

The decision addresses issues at the center of the national debate over the health system marketplace and provider-insurer contracting, and it highlights Faegre Drinker’s deep experience defending health care clients in consequential antitrust litigation.

The Faegre Drinker antitrust team, which took the lead for Defendants in opposing class certification, included partners Paul Saint-Antoine, Ken Vorrasi, John Yi, and Alison Agnew, counsel Jon Todt, and associates Matt Lechner, Nick Merrill, Katrina Meyer, and Kennedy Ferry.

The team received a “Shout Out” in The American Lawyer’s "Litigator of the Week" coverage.