Prairie State Wire

A U.S. District Court has allowed class action plaintiffs to proceed with lawsuits against MultiPlan and a group of insurers, alleging antitrust violations related to deceptive reimbursement practices.

The American Medical Association (AMA) and the Illinois State Medical Society (ISMS) initiated a lawsuit against MultiPlan last October in federal court. They aim to halt what they describe as a multilateral price-fixing conspiracy involving commercial health insurance companies. This alleged scheme reportedly led to "artificially" low reimbursement rates for out-of-network services provided by physicians.

In March, the U.S. Department of Justice filed a Statement of Interest in a private class action that accuses MultiPlan of antitrust violations connected to “algorithmic pricing.”

MultiPlan, which recently rebranded as Claritev, saw its profit levels increase significantly over the past decade. The company’s revenues from repricing services surged from $23 million in 2012 to $709 million in 2021.

The AMA is actively working to engage individual physicians affected by these practices. ISMS plans to provide further updates on how impacted practices can get involved.

For inquiries, individuals are encouraged to contact the ISMS Legal Division via email.