ArMA Joins Lawsuit Against MultiPlan & Leading Insurance Providers Over Health Care Price-Fixing

Federal antitrust litigation seeks to hold MultiPlan and major insurance companies responsible for an alleged coordinated price-fixing scheme and resulting under-reimbursement for out-of-network services.

PHOENIX, Arizona — The Arizona Medical Association (ArMA) has joined a federal multi-district litigation against MultiPlan (rebranded to Claritev) and major insurers, including UnitedHealth, Elevance, Humana, Aetna, and Cigna, alleging they conspired to systematically underpay healthcare practitioners for reimbursements for out-of-network services, which often fail to cover operating costs. MultiPlan goes by many names, including Data iSight, Viant, NCN, ProPricer, and MARS. As of 2024, MultiPlan processes more than 80% of all commercial out-of-network reimbursement claims in the United States.

ArMA joins the American Medical Association (AMA) and hundreds of physician practices and facilities nationwide in this growing antitrust litigation. Plaintiffs allege that MultiPlan facilitated a price-fixing agreement among insurers that artificially suppressed out-of-network payment rates, costing clinicians billions of dollars. This lawsuit, filed in the Northern District Court of Illinois in 2024, seeks to end MultiPlan’s alleged anticompetitive scheme, which it has operated since at least 2015, and recoup financial damages for practitioners and practices.

“For many years, physicians in Arizona have been forced to accept increasingly insufficient reimbursements for providing healthcare to out-of-network patients,” said ArMA President Dr. Jason Jameson. “This lawsuit is an important step to ensure that physicians are justly reimbursed for the care we provide — not only today, but also for historical underpayments going back more than a decade — and end this alleged illegal collusion that hurts patients.”

Physicians who believe they have been harmed by MultiPlan and the insurance companies, whether current or in past years, can obtain a free case evaluation from one of the attorneys appointed by the court to lead the non-class claims. Clinicians may not always know whether MultiPlan — or one of its services, such as Data iSight, Viant, NCN, ProPricer, or MARS — re-priced their claims. However, clues can often be found in Explanations of Benefits or remittance advice.

The court has also appointed attorneys to litigate a proposed antitrust class action on the same issues, but a ruling on any proposed class certification is not expected until 2027. Physicians who believe they have been impacted by MultiPlan’s conduct can choose to pursue their claims individually on a non-class basis now and do not need to wait for any ruling on a proposed class.

"The Arizona Medical Association is dedicated to helping physicians navigate the increasingly turbulent and complicated landscape of healthcare so they can focus on what matters most: patient care," shared ArMA CEO Doug Laher, MBA, CAE. "We're proud to be a part of this historic lawsuit, which aims to protect and support those who heal our communities."

Members of the Arizona Medical Association interested in joining the lawsuit as litigants are eligible for discounted contingency fees. Anyone who would like to learn more about the case can do so by emailing communications@AZmed.org.