Antitrust suit accuses MultiPlan, national payers of restricting $90B in provider payment

A lawsuit filed by the liquidating trust for Verity Health is claiming MultiPlan and national insurers used their influence to deny providers across the country $90 billion since 2012. 

The lawsuit, filed Sept. 8 in a California court, accuses MultiPlan of forging a "hub, spoke, and rim" agreement with major payers to artificially reduce out-of-network reimbursement for providers. MultiPlan then allegedly received a cut of money saved on the lower reimbursement rates, according to a news release from the law firm representing the liquidating trust. 

Blue Shield of California, UnitedHealth, Cigna, Anthem, Centene, Humana and Aetna all allegedly agreed to participate in MultiPlan's arrangement, according to court documents. 

The practices outlined in the lawsuit allegedly violate California's Cartwright Act and Unfair Competition Law and cost providers, including Verity, a collective $10 billion annually since 2012, or $90 billion total.

MultiPlan told Becker's it denies the allegations levied against its business and its clients. 

"MultiPlan does not believe the lawsuit has any merit and we will vigorously contest these baseless claims against us and our clients," a spokesperson for the company told Becker's

Verity Health declared bankruptcy in 2018, selling business assets through much of 2020.

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