Dear Members:
Earlier this month, the Association of New Jersey Chiropractors joined the MultiPlan Antitrust Litigation as a plaintiff. This is a federal antitrust action against MultiPlan (recently rebranded as Claritev), a healthcare data firm, and leading health insurance companies, including UnitedHealth, Elevance (Anthem), Humana, Aetna,Cigna, and various Blue Cross Blue Shield (BCBS) entities. MultiPlan goes by many names, including Data iSight, Viant, NCN, ProPricer, and MARS. Plaintiffs allege that MultiPlan, using Data iSight, Viant, and other services, facilitated a horizontal price-fixing agreement among insurers that artificially suppressed out-of-network payment rates and cost providers billions of dollars.
Plaintiffs, including the ANJC, the American Medical Association, and some of the largest health systems and hospital staffing organizations in the country, allege these companies participated in a coordinated price-fixing conspiracy to generate billions in profits for MultiPlan and insurance providers by forcing practitioners to accept increasingly low reimbursements for out-of-network services. The litigation seeks to end this illegal conduct as well as recoup financial damages for practitioners and healthcare providers who were harmed by this conduct.
The lawsuits against MultiPlan have been consolidated into a multi-district litigation filed in the Northern District of Illinois before Judge Matthew Kennelly. In March 2025, the Department of Justice filed a statement of interest in the litigation, and in June 2025, Judge Kennelly denied the defendant’s motion to dismiss the antitrust claims, allowing the case to proceed to discovery.
The ANJC will keep you updated as the case progresses.
What are the allegations?
- Since at least 2015, MultiPlan has forced practitioners to accept increasingly low payments for out-of-network services, with the most aggressive and widespread underpayment occurring between approximately 2016 and 2022, which often do not cover providers’ 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 practitioners for out-of-network healthcare services.
- MultiPlan left providers with little room to negotiate its offered reimbursement rates and requires that practitioners who accept reimbursement not pursue additional balances owed by patients.
What does this mean for members?
- The ANJC 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 up to 10 years. Practitioners should consider not only current reimbursement levels, but also historical claims, when assessing potential damages. Many practices that have been out-of-network with one major insurer during the relevant time period will have compensable claims.
- Even practices that believe they were “used to” low out-of-network rates during this period may be entitled to recover damages for unlawful price-fixing that went unchallenged at the time.
- Providers may not always know whether MultiPlan, or one of its services like Data iSight, Viant, NCN, ProPricer, or MARS, re-priced their claims. Clues can often be found in Explanations of Benefits or remittance advice.
How can individual practitioners learn more?
- You can reach out to one of the following lawyers, each of which has been appointed manage 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.
- The court also has 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. Providers who believe they have been impacted by MultiPlan’s conduct can join the litigation individually on a non-class basis and do not need to wait for any ruling on a proposed class.
Please reach out to info@anjc.info with questions.
Sincerely,
Dr. Steven Clarke
ANJC Board President
UPCOMING WEBINARS: February 4 and February 12
Join the Association of New Jersey Chiropractors for a timely webinar on what this case means for practitioners and facilities nationwide. Matt Lavin, AGG Healthcare Litigation partner and Jennifer Scullion, partner at Seeger Weiss, members of the Executive Committee for direct-action plaintiffs, will walk through the litigation’s origins, key legal developments and strategies for affected providers to consider. He will also explain why now it is important to evaluate your potential participation in the case and to support industry reform.
The court also has 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. Providers who believe they have been impacted by MultiPlan’s conduct can join the litigation individually on a non-class basis and do not need to wait for any ruling on a proposed class.
The session will conclude with a Q&A – and open discussion is welcome and appreciated. All participant information will be kept private.