A new antitrust lawsuit accuses MultiPlan and about two dozen insurers and plan administrators of working together to suppress out-of-network payouts.
Filed July 9, 2026 in the U.S. District Court for the Northern District of Illinois, the complaint comes from HealthLGX, a company that holds claims assigned to it by a long roster of emergency room and other physician practices. It folds into a larger consolidated case, In re MultiPlan Health Insurance Provider Litigation.
The theory should interest anyone who reprices out-of-network claims. When a patient sees a provider outside their network, the insurer decides how much to pay. According to the complaint, MultiPlan - now called Claritev - sells insurers a "common pricing methodology" many of them use to set those amounts, and the insurers used it, together, to push payments below competitive levels.
The filing calls the arrangement the "MultiPlan Cartel." It says roughly "700 payors" take part, that participants account for "over 80% of all out-of-network payments by dollar volume," and that MultiPlan and its "co-conspirators control approximately 80-90% of the national market for out-of-network reimbursement by dollar volume."
The sharpest claim for carriers is the alleged spillover. HealthLGX argues the suppression did not stay inside the group using MultiPlan. It says the low payments were fed into FAIR Health, the independent nonprofit whose data other insurers use to set their own rates. FAIR Health was set up in 2009 to replace an earlier database, Ingenix, that the filing calls "manipulated." Once cartel members allegedly began "systematically suppressing out-of-network reimbursement rates starting in approximately 2015," the complaint says, those numbers began to "systematically pull down the benchmark rates."
The upshot, according to the complaint: even insurers that never used MultiPlan ended up paying less, because the benchmark data had allegedly been tainted. Since members "abandoned FAIR Health and adopted MultiPlan's pricing methodology," the filing says, "reimbursement rates have decreased year-over-year" - reversing a pre-2016 pattern in which they "typically rose over time."
The core claims run under Section 1 of the Sherman Act, the federal law against agreements that restrain trade, alongside state antitrust and consumer-protection statutes and unjust-enrichment claims under Pennsylvania and New Jersey law. HealthLGX wants treble damages - triple the losses, standard in antitrust - plus disgorgement and an order halting the conduct. It has demanded a jury.
The defendants named in this filing include UnitedHealth Group, Aetna, The Cigna Group, Elevance Health (formerly Anthem), Humana, Centene, Molina Healthcare, Kaiser Foundation Health Plan, several Blue Cross Blue Shield entities and MultiPlan itself, among others.
A note for claims teams: this is a short-form complaint that adopts a larger master complaint by reference, so it quotes no specific policy or plan language. The dispute is over pricing methodology and market conduct, not any single policy's wording.
None of the allegations have been tested in court. The claims are unproven, and no judge has ruled.
