Healthcare Providers Score Win as Court Allows MultiPlan Price-Fixing Class Action to Proceed

A class action lawsuit against MultiPlan and major health insurers will proceed after a federal judge in Chicago substantially rejected the defendants’ motions to dismiss. Filed by Berger Montague, along with co-counsel Edelson PC and Susman Godfrey LLP, the suit alleges that MultiPlan (now Claritev) and these insurers engaged in a price-fixing scheme to suppress out-of-network payments to healthcare providers nationwide through MultiPlan’s pricing and negotiation services. The Honorable Matthew F. Kennelly found that the plaintiffs plausibly alleged this scheme, allowing the case to move forward.

The ruling emphasized that while parallel conduct alone is insufficient to prove antitrust violations, the plaintiffs presented additional facts indicating an agreement. The Court highlighted allegations that the insurers acted against their own economic self-interest by using MultiPlan’s services—despite risks of losing subscribers—and shared competitively sensitive information through MultiPlan, which in turn aligned payment rates among competitors. The Court concluded that this conduct went beyond independent business decisions and constituted a plausible horizontal agreement to fix prices.

“By collectively utilizing MultiPlan’s price-setting services, these insurers have fixed out-of-network prices at artificially suppressed levels, causing significant financial damage to a vast number of healthcare providers,” said Berger Montague Shareholder Zachary D. Caplan. “The Court’s decision recognizes this is not mere parallel behavior, but a coordinated scheme to suppress competition and payments to providers. We look forward to proceeding into discovery,” said Mr. Caplan.

The class action names MultiPlan, along with Aetna, Inc., The Cigna Group, UnitedHealth Group, Inc., and members of the Blue Cross Blue Shield Association. Plaintiffs allege these defendants and their co-conspirators shared sensitive pricing information and aligned out-of-network payment strategies via MultiPlan, systematically paying providers far below competitive market levels for out-of-network care.

Read more about the class action case on behalf of healthcare providers at www.bergermontague.com/multiplan.

Berger Montague is one of the nation’s preeminent law firms focusing on complex civil litigation, class actions, and mass torts in federal and state courts throughout the United States. The firm is active in the fields of antitrust, commercial litigation, consumer protection, defective products, environmental law, employment law, securities, and whistleblower cases, among many other practice areas. For more than 50 years, Berger Montague has played lead roles in precedent-setting cases and has recovered over $50 billion for its clients and the classes they have represented. Berger Montague is headquartered in Philadelphia and has offices in Chicago; Malvern, PA; Minneapolis; San Diego; San Francisco; Toronto, Canada; Washington, D.C., and Wilmington, DE.