Sept. 12, 2025

WSMA Joins MultiPlan Antitrust Litigation

The WSMA has joined a federal antitrust lawsuit currently underway against MultiPlan (recently rebranded to Claritev), a health care data firm, and major health insurance companies including UnitedHealth, Elevance (Anthem), Humana, Aetna, Cigna, and various Blue Cross Blue Shield entities. The litigation, brought forward by the American Medical Association and the Illinois State Medical Society, alleges that these companies participated in a coordinated price-fixing conspiracy to generate billions in profits for MultiPlan and insurance providers by systematically underpaying out-of-network physician practices and health care facilities. The litigation seeks to end this illegal conduct as well as recoup financial damages for physician practices, physician assistants, and other health care practitioners who were harmed by this conduct.  

The case has made significant progress, with the Department of Justice filing a statement of interest in March 2025 and the court denying defendants' motion to dismiss in June 2025, allowing the litigation to proceed to discovery.

Physician practices and health care practitioners who have been out of network with major insurers may be entitled to financial damages for claims dating back up to 10 years. If you are interested in learning more, you can contact one of the lawyers appointed by the court to lead non-class claims or access resources, including a free case evaluation.

What are the allegations?

• Since at least 2015, MultiPlan has forced physicians to accept increasingly low payments for out-of-network services, which often do not cover their operating costs.

• Insurance companies like UnitedHealth, Anthem, and Cigna provided MultiPlan with competitively sensitive, confidential information on pricing and reimbursement rates that they could not have otherwise legally shared with each other.

• MultiPlan then used this data in its proprietary algorithm to develop and set substandard reimbursement rates to pay physicians for out-of-network health care services. 

• MultiPlan left physicians with little room to negotiate its offered reimbursement rates and required that physicians who accept reimbursement not pursue additional balances owed by patients.

What does this mean for members?

• The WSMA joining the lawsuit does not make our members individual plaintiffs.

• Your practice may be entitled to significant financial damages against MultiPlan and other insurance companies. You can speak to an attorney today.

• Claims against MultiPlan over out-of-network reimbursements may go back as far as 10 years. Many practices that have been out of network with one major insurer during the relevant time period will have compensable claims.

How can physicians learn more?

• You can reach out to the three lawyers who have been appointed as co-lead counsel in the litigation for non-class plaintiffs: Matthew M. Lavin of Arnall Golden Gregory (the direct lawyer for the AMA and ISMS); Hunter J. Shkolnik of Napoli Shkolnik Attorneys at Law; and Jennifer Scullion of Seeger Weiss LLP. You can start a free case evaluation here.

• You can watch a recorded webinar hosted by Matt Lavin of Arnall Golden Gregory. Passcode: NwyPS?1?