Arizona Attorney General Kris Mayes accused healthcare data company MultiPlan, rebranded as Claritev, and eight health insurers of a price-fixing scheme.
The complaint, filed in state court, alleged MultiPlan — along with Aetna, Cigna, UnitedHealth Group, Humana, Elevance Health, Health Care Service Corp., Centene and Molina Healthcare — were “effectively forming a buyer’s ‘cartel.'”
The lawsuit specifically highlighted the PlanOptix tool, which houses pricing data across payers. The insurers can access this data and benchmark their pricing against competitors, an executive cited in the complaint said. The lawsuit also targets MultiPlan’s PPO networks, which are rented out to insurer clients. Providers join under the promise of “attractive” rates, but insurers can treat these claims as out of network. MultiPlan’s algorithm reprices charges regardless of quality of care and other criteria, the complaint alleged.
“By using a shared algorithm to set payments, these companies harmed doctors and patients alike — driving up patients’ risk of paying more out‑of‑pocket costs, depriving providers of fair payment and sometimes forcing them to accept payment below the costs incurred for treatment, and making it harder for Arizonans to get the care they needed,” Ms. Mayes said in a June 1 news release. “This case is another example of old-fashioned price-fixing using new technology, but it’s against the law all the same.”
The lawsuit said, during negotiations with MultiPlan, providers are “effectively negotiating against the entire industry.” The complaint said MultiPlan’s client advisory board meetings pushed for out-of-network pricing cuts, as well.
The damages period spans back to 2015. The complaint requested restitution, disgorgement of inappropriate gains, civil penalties up to $150,000 and $10,000 per violation under the Arizona Uniform State Antitrust Act and the Arizona Consumer Fraud Act, respectively, a jury trial, and other fees.
“We deny the allegations and will defend ourselves vigorously,” an Aetna spokesperson told Becker’s.
The Capitol Forum recently reported that Claritev is facing a Justice Department antitrust investigation, but the company said it had only received a confidential grand jury subpoena in 2024.
In March, the Arizona Medical Association said it joined federal multi-district litigation against MultiPlan. One year ago, a federal judge allowed state antitrust and consumer protection claims to progress. Not all lawsuits have historically survived, though, including one involving UnitedHealthcare that a federal judge tossed in 2025 and another that a California judge dismissed in 2024. A Claritev spokeperson emphasized these cases.
“We are aware of the complaint filed by the Arizona attorney general against MultiPlan, now known as Claritev. This lawsuit lacks a basic understanding of what our solutions do and don’t do. The allegations are unequivocally without merit, and the company stands by its position that it complies with state and federal antitrust laws,” the spokesperson told Becker’s. “The complaint ignores the real challenge facing patients and the healthcare system: opaque and inflated out-of-network billing. When out-of-network payment disputes are not grounded in data, structure and accountability, patients can face surprise bills, balance billing, higher premiums, reduced benefits and confusion about what they owe.”
Becker’s contacted the insurers for comment and will update this story if more information becomes available.
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