Members of the Illinois Nurses Association this week said Prime Healthcare is placing profits over patient and worker welfare.

Nurses at Saint Joseph Medical Center in Joliet, one of seven Illinois hospitals Prime took ownership of in March 2025, cited what they said are unfair labor conditions for employees and unsafe practices for patients at the Prime Healthcare run hospital.

But in addition to service and staffing cuts, the INA also noted that patients may soon be paying higher costs, depending on which insurance carrier they have.

In a news release, the union noted that Blue Cross Blue Shield patients in Illinois received a letter from their insurance company recently stating “Prime is trying to break their contract” with the agency and that “Starting June 1, 2026, Blue Cross patients will have to find alternative care or face high out-of-network costs.”

In a written response, Prime Healthcare said it “always places patient care and quality at the center of all we do and is nationally recognized for quality by U.S. News & World Report, the Lown Institute, and Healthgrades.”

Blue Cross Blue Shield of Illinois reportedly serves between 7 million and 9 million people statewide.

“They are purposefully trying to leave the network so they can gouge patients,” Cardiac nurse Amber Velasquez said.

When asked for comment about the Blue Cross Blue Shield network agreement, a Prime spokesperson said in an email that the insurer had sent out the notice preemptively, and that negotiations are still ongoing.

“Prime Healthcare has been working in good faith Blue Cross Blue Shield of Illinois to resolve issues and reach a fair agreement that allows us to continue providing care to BCBSIL members at our hospitals and physician practices across Illinois that provide essential services to thousands of residents annually,” the California-based company said in a statement.

“Unfortunately, BCBSIL’s recent letter to their members may create unnecessary concern for patients while negotiations are still ongoing. Our goal is to reach an agreement that protects patients access while ensuring hospitals can continue to provide high-quality care in the communities we serve.”

Even if negotiations are still ongoing, it is possible that a deal will not be reached in time to guarantee coverage for patients past the end of the month.

This would not be the first time Prime has been at odds with an insurer. The company is currently being sued by Anthem Blue Cross Life and Health Insurance Company and Blue Cross of California for billing concerns and what the company described as “gouging the healthcare system” in California.

In the lawsuit, which was filed in January, Anthem accuses Prime-owned hospitals of “canceling longstanding network contracts to extract higher reimbursement for the same services.”

Prime has a history of litigation with other companies and the federal government over insurance claims dating back two decades.

According to a 2016 report from the National Association of Medical Doctors’ Journal of Medicine, provided by the INA, “prime often cancels insurance contracts at its newly acquired hospitals, enabling it to charge the insurers higher rates for treating their members.”

In 2008, Prime had a legal battle with Kaiser Insurance, after Prime hospitals sent collection notices to 6,000 Kaiser-insured patients. The insurance company challenged what it called the “grossly inflated charges” and the two companies eventually settled outside of court after a judge enjoined Prime from pursuing the collections.

The U.S. Department of Justice also accused Prime in 2016 of insurance fraud, claiming that the company would admit emergency room patients as inpatients to collect higher reimbursements from Medicare and Medicaid, a practice which the government said resulted in patients receiving “medically unnecessary treatment” and “spending more time in the hospital than they should have.”

During the investigation, over a million of Prime’s reimbursement claims were rejected over the course of eight years.

Prime denied any wrongdoing at the time and stated that patients were being admitted on the judgement of hospital doctors, though as of 2021 the DOJ reported that the company has paid over $100 million in settlements for claims of false claims and over billing.

Prime’s plans for expansion

In addition to Saint Joseph in Joliet Prime Healthcare currently owns other hospitals in Illinois including Holy Family Medical Center in Des Plaines, Mercy Medical Center in Aurora, Resurrection Medical Center in Chicago, Saint Joseph Hospital in Elgin, and Saint Mary of Nazareth Hospital in Chicago. The company’s non-profit Prime Healthcare Foundation controls St. Mary Hospital in Kankakee and Saint Francis Hospital in Evanston.

The company is also in the process of acquiring Franciscan Health in Olympia Fields.

“The Illinois Health Facilities and Services Review Board, doesn’t have a mechanism to deny a sale if everything is in order,” said Margot Gislain, lead legislative coordinator for the Illinois Nurses Association. “They don’t have any real power.”

Currently, the Illinois State Senate’s Health and Human Services Committee is considering two bills, HB4757 and HB5000, which would create more oversight over Prime and similar healthcare entities.

State Sen. Karina Villa, D-West Chicago, whose district includes Mercy Hospital in Aurora and who serves as chair of the Health and Human Services Committee, said HB4757 would “actually put teeth in and give the ability for us to fight back.”

The bill would give the Illinois Health Facilities and Services Review Board more authority to enforce conditions on sales of hospitals and to prevent the closure of hospital units.

Meanwhile, HB5000 would give the Illinois Attorney General’s office “more oversight over for-profit and private equity firms operating healthcare facilities.”

Similar mechanisms in California killed the acquisition of six hospitals by Prime in 2015, when then-Attorney General Kamala Harris insisted that the company could only purchase the hospitals if they promised to continue all existing services at the underperforming hospitals for 10 years.

When it acquired the seven hospitals from Ascension in 2025, Prime said it would not shutter facilities or significantly reduce services for at least two years, however, the Illinois Health Facilities and Services Review Board had no way to guarantee that promise.

“This is the first for-profit company we’ve dealt with in Illinois hospitals and everyone was caught off-guard by how much they could do,” said Gislain. “They’ve been operating with impunity.”

Prime’s spokesperson, said the company had “saved” the struggling Illinois hospitals from “a period of significant financial distress” and stated that patient care is a priority for the company.

Both bills in the State Senate have been passed by the House and must be approved by May 31 in order to be enacted by Gov. JB Pritzker.