A federal antitrust lawsuit is underway against MultiPlan, now known as Claritev, and several major health insurance companies, including UnitedHealth, Elevance (Anthem), Humana, Aetna, Cigna, and various Blue Cross Blue Shield entities. The case alleges that these organizations engaged in a coordinated price-fixing scheme that suppressed out-of-network payment rates for physicians and healthcare facilities.
The plaintiffs claim that insurers used MultiPlan’s pricing tools to keep payments at artificially low levels. This practice may have led to lower reimbursements for many medical practices across the country, including those in Colorado. Physicians may not always be aware of MultiPlan’s involvement because it is sometimes not clearly indicated on Explanations of Benefits or remittance advice.
Recent developments in the litigation include a statement of interest filed by the U.S. Department of Justice in March 2025 and a federal court decision in June 2025 denying the defendants’ motion to dismiss. These actions allow the case to proceed into discovery and indicate that the allegations are being taken seriously by federal authorities.
Physicians who received out-of-network payments from major insurers could be eligible to seek financial damages for claims going back up to ten years. They do not need to wait for class action certification to pursue recovery; attorneys have been appointed by the court to lead individual claims. A proposed class action is also progressing, but a decision on class certification is not expected until 2027.
The Colorado Medical Society (CMS) has stated: “CMS is sharing this information as part of our ongoing commitment to defending the economic viability of physician practices and pushing back against unfair payer practices. Whether through advocacy at the Capitol, regulatory reform, or monitoring high-impact litigation like this, CMS works to ensure physicians have the information and support they need to protect their practices.”
