Data analytics firm MultiPlan is facing another lawsuit alleging that it conspired with major payers to underpay providers by tens of billions annually.
The lawsuit, filed by Shreveport, La.-based Allegiance Health Management, alleges that by 2022, MultiPlan used its repricing tools to fix prices on 370,000 out-of-network claims daily for more than 700 payers, which has resulted in $22 billion in underpayment annually. Underpayments purportedly rose to $22.9 billion in 2023.
The for-profit system's lawsuit was filed April 22 in an Illinois federal court and also names payers Health Care Service Corp., Aetna, Elevance, Centene, Cigna, UnitedHealth Humana and Kaiser Permanente.
Allegiance alleges the "widespread use of MultiPlan's repricing tools, particularly among the biggest health insurers, gives plaintiffs no realistic option other than accepting these artificially suppressed reimbursement rates."
"The sheer volume of reimbursement claims makes it impracticable for plaintiffs to negotiate with MultiPlan," the lawsuit alleges. "And even if they had the time and resources for negotiations, MultiPlan would benefit from knowing that it repriced the claims as part of a nationwide conspiracy with its largest competitors, giving the providers nowhere to turn for relief."The system said it will calculate the full amount of damages after discovery and prove them in a jury trial.
Allegiance is seeking to recover damages "to the maximum amount allowed under the applicable laws" for itself and class members, according to the suit.
MultiPlan declined to comment to Becker's on the lawsuit.
MultiPlan is facing similar allegations in a 2023 lawsuit filed by Altamonte Springs, Fla.-based AdventHealth. That case remains pending in a New York federal court. Both lawsuits quote an unnamed analyst who referred to MultiPlan as acting as "a mafia enforcer for insurers."
Allegiance's suit comes after The New York Times reported April 7 that major insurers made millions in fees by using MultiPlan to determine how much to pay providers for out-of-network claims. MultiPlan said in an April 8 statement it "fundamentally disagrees" with its depiction in the article. MultiPlan customers rely on the company to avoid costly negotiations with providers, it said in its statement. UnitedHealthcare, Cigna and Aetna told the Times in separate statements MultiPlan helps them control costs for employers. Providers often charge "egregious" out-of-network prices, a UnitedHealthcare spokesperson told the Times. Cigna told the outlet some providers are charging rates more than 1,000% of Medicare rates for out-of-network claims.