A hospital giant says insurers used an algorithm to underpay its bills - and a grand jury is already circling.
Lifepoint Corporate Services, a partnership tied to one of the largest hospital systems in the country, has sued MultiPlan - now called Claritev - along with a lineup of major health insurers. The complaint, filed June 2, 2026 in federal court in Chicago, accuses them of running what it calls the "MultiPlan Cartel" to drive down out-of-network reimbursement rates.
The plaintiff holds claims assigned from Lifepoint Health and its affiliates. According to the complaint, Lifepoint runs 135 hospitals as of 2026, employs nearly 55,000 healthcare workers, and treats patients across 33 states.
The mechanism is simple to describe. When Lifepoint treats insured patients out-of-network, it bills the insurer. The filing says the payors handling most of those bills used MultiPlan's repricing services - and that those services systematically underpaid.
The named defendants include Aetna, The Cigna Group, Kaiser Foundation Health Plan, Elevance Health (formerly Anthem), Blue Cross Blue Shield of Michigan, Blue Cross Blue Shield of Massachusetts, CareFirst of Maryland, BCBSM, Inc., which does business as Blue Cross Blue Shield of Minnesota, Allied National, Central States Southeast and Southwest Areas Health and Welfare Fund, and Health Net of California.
The complaint puts numbers to the pattern. It says Lifepoint billed $1,304 for one behavioral health claim, and MultiPlan's algorithm, Data iSight, set the price at $696. On a rehabilitation evaluation billed at $1,054.58, the filing says Data iSight set the price at $402.31. Total damages, the complaint claims, run "at least in the tens of millions of dollars."
One defendant draws special attention. The filing alleges Health Net of California gave MultiPlan authority over its out-of-network pricing, and that company executives began attending what the complaint calls "MultiPlan Client Advisory Board Meetings" in 2019. It says two employees - a senior network management director and a long-time manager - attended on the company's behalf. In the first quarter of 2025 alone, the complaint alleges, Health Net of California "processed $44.6 million in changes through Data iSight, generating $36.3 million in underpayments."
The filing also points to a criminal investigation. It says the Justice Department's Antitrust Division "is investigating the MultiPlan Cartel," and that in a May 18, 2026 SEC filing, MultiPlan "acknowledged for the first time that it received a grand jury subpoena in August 2024."
Here's why claims professionals should care: this case goes after the plumbing of out-of-network pricing. The theory is antitrust - that insurers and a repricer coordinated through a shared algorithm instead of competing. The complaint also argues that Lifepoint's in-network deals with Aetna, Cigna and Kaiser don't force these out-of-network disputes into arbitration.
The filing asserts four counts under Section 1 of the Sherman Act, including a "Hub-And-Spoke Agreement in Restraint of Trade," and demands a jury trial. It seeks compensatory damages, treble damages, punitive damages, disgorgement, and an injunction.
The allegations have not been tested in court. The defendants have not yet responded, and no court has ruled.
