The Texas Medical Association has joined a federal multidistrict litigation against MultiPlan and several major insurers, alleging a price-fixing scheme that suppressed out-of-network reimbursement rates, according to an April 7 news release shared with Becker’s.
The lawsuit, filed in 2024, claims MultiPlan — which also operates as Data iSight, Viant, NCN, ProPricer and MARS — colluded with insurers including UnitedHealth, Elevance, Humana, Aetna and Cigna to underpay healthcare practitioners for out-of-network services.
Plaintiffs allege the arrangement has cost physicians and providers billions of dollars since at least 2015 and that reimbursements often fail to cover operating costs. MultiPlan, which rebranded as Claritev in 2025, processes more than 80% of all commercial out-of-network reimbursement claims in the United States as of 2024, according to a news release from the California Medical Association, which is also a plaintiff in the suit.
The litigation seeks to end the alleged anticompetitive practices and recover financial damages.
A proposed antitrust class action is also pending, with a ruling on class certification not expected until 2027, according to the TMA release.
In a similar case April 6, a judge for the U.S. District Court for the District of Massachusetts denied a motion to dismiss a lawsuit alleging an antitrust conspiracy by healthcare technology company Zelis and five major health insurers. In 2024, a California judge dismissed another lawsuit against MultiPlan, where a health system alleged billions in denied provider payments.
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 18–20 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
