Atrium Health scored an early courtroom win on Tuesday when a judge rejected the state of North Carolina’s request for a temporary restraining order on an affordability program the health system plans to implement for State Health Plan members in the 2027 calendar year.

The Atrium Health Affordability Protection Program, unveiled last week, would lower members’ out-of-pocket costs but, according to the State Treasurer of North Carolina’s office, effectively shift those costs back to the plan.

Notably, the cost sharing would make Atrium’s facilities more appealing to plan members than other health systems in the state with lower rates. The office had recently implemented a Preferred Provider Program, authorized under state statute, that reduced members’ copays if they received care from the lower cost providers.

Atrium, which only had some of its services and locations designated as a preferred provider, announced its Affordability Protection Program bringing copays even lower than those in the state’s Preferred Provider Program “to deceive Plan participants into believing” that its services were lower cost, the state wrote in a complaint filed last Friday. In reality, the state said, Atrium’s program would “maintain higher reimbursement rates … without reducing the overall cost of services, particularly for high-cost services and very sick patients who use a significant number of services.”

The treasurer in recent weeks has described Atrium’s program as unlawful and a “shell game” that would bankrupt the plan. The state also alleged in its complaint that Atrium acted in bad faith by waiting until just days before the 750,000-member plan’s open enrollment period to sow confusion among plan members and “undermine” the state’s program.

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