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US judge rules health insurers, MultiPlan must face price-fixing lawsuits
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US judge rules health insurers, MultiPlan must face price-fixing lawsuits
Jun 3, 2025 2:44 PM

June 3 (Reuters) - A U.S. judge on Tuesday said

healthcare providers can pursue claims that technology provider

MultiPlan and a group of insurers conspired to underpay them

billions of dollars in reimbursements for out-of-network health

services.

U.S. District Judge Matthew Kennelly in Chicago ruled that

doctors and other providers who filed the proposed class action

had plausibly alleged a price-fixing conspiracy that relied on

insurers collectively sharing sensitive information with

MultiPlan to set reimbursement rates.

MultiPlan, which rebranded as Claritev ( CTEV ) in February,

processes payments for out-of-network healthcare services. Major

insurers, including defendants UnitedHealth ( UNH ), Aetna and Cigna ( CI ),

have contracts with the company and use its software.

In a statement on Tuesday, MultiPlan said it was "confident

in the strength of our legal position" and that the lawsuits

have no merit.

Aetna parent CVS in a statement said, "we stand ready to

argue the substantive facts of the case and defend ourselves

vigorously in this matter."

UnitedHealth ( UNH ) and Cigna ( CI ) did not immediately respond to

requests for comment. All of the defendants have denied any

wrongdoing.

Kennelly is presiding over consolidated lawsuits that were

first filed in 2023.

MultiPlan processes more than 80% of out-of-network claims

across the country, or abut 370,000 daily claims, according to

the plaintiffs.

In a statement, attorneys for the health providers said

MultiPlan and the insurance defendants "orchestrated a cartel

through the sharing of competitively sensitive confidential

pricing information to illicitly coordinate on out-of-network

reimbursements."

MultiPlan and the insurers have argued that health providers

are free to reject an insurance company's payment and instead

seek full compensation from patients. MultiPlan told the court

its services provide industry more flexibility, lowering costs

to insurers and patients.

Kennelly in his ruling said "whether or not MultiPlan's

calculated rates are labeled as 'recommendations,' the

plaintiffs plausibly allege that they are more akin to

mandates."

The U.S. Justice Department submitted a court filing in

March backing claims in the health providers' case.

The case is In re MultiPlan Health Insurance Provider

Litigation, U.S. District Court for the Northern District of

Illinois, No. 1:24-cv-06795.

Read more:

US Justice Department backs medical providers' lawsuit over

data analytics software

Hospital sues data analytics company MultiPlan in US court

antitrust case

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