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MultiPlan and Insurers Move to Dismiss Antitrust Allegations Amid Growing Legal Challenges

By  |  January 19, 2025
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MultiPlan and its health insurer partners have filed a motion to dismiss a consolidated lawsuit that accuses the company and insurers of engaging in anticompetitive practices. The motion, submitted on Thursday, responds to allegations brought by numerous provider organizations and the American Medical Association, according to FiercePharma. The case has been consolidated into multidistrict litigation that combines complaints from dozens of plaintiffs.

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    The providers allege that MultiPlan collaborated with major insurers, including UnitedHealth Group, Elevance Health, Aetna, and Cigna, to implement out-of-network reimbursement rates based on a shared data methodology. This approach, they argue, undermines competition and effectively fixes prices. In their December filing, the plaintiffs labeled this arrangement the “MultiPlan Cartel,” asserting that it resulted in significant underpayments—approximately $19 billion in 2020 and $6.4 billion in just the third quarter of 2024.

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    Per FiercePharma, MultiPlan and the insurers countered these claims, arguing that the plaintiffs failed to establish the necessary elements of an antitrust case. They contended that their reimbursement system relies on publicly available data, not proprietary competitor data, and that similar lawsuits against MultiPlan have been dismissed in the past for insufficient evidence.

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    In their motion, legal representatives for MultiPlan and the insurers emphasized that the plaintiffs lack antitrust standing and have not demonstrated the existence of a standalone product or specific antitrust conspiracy. They also noted that prior cases involving some of the same plaintiffs have not held up in court.

    The provider plaintiffs and their legal team dismissed these arguments, stating the motion has no merit. “MultiPlan conspired with major insurers to orchestrate a price-fixing cartel that has devastated healthcare access across America,” the attorneys asserted in a statement. They highlighted the financial strain this alleged scheme has placed on healthcare providers, particularly those in rural areas, where nearly 30% of hospitals are at risk of closure.

    The litigation, according to the plaintiffs, seeks to dismantle what they describe as a conspiracy that harms both healthcare providers and patients. They argue that restoring competition to the out-of-network payments market is essential to ensuring fair compensation for doctors and maintaining access to quality care for all Americans.

    Source: FiercePharma