MultiPlan Out-of-Network Provider Litigation
$19 Billion.
Estimated Underpayments per year
About the case
About the case
What is the multiPlan litigation?
The Case
A consolidated multidistrict litigation (MDL) before Judge Matthew F. Kennelly in the Northern District of Illinois alleging a price-fixing conspiracy that systematically underpaid out-of-network (OON) healthcare providers.
The Alleged Scheme
MultiPlan (rebranded as Claritev) and 30+ major insurers allegedly colluded to suppress OON payments by sharing pricing data and using proprietary tools to artificially lower reimbursement rates across the entire market.
MultiPlan Litigation Case Overview
Do you qualify?
The MultiPlan healthcare antitrust litigation involves allegations that major health insurers coordinated with MultiPlan, which has rebranded as Claritev, to suppress reimbursement rates for out-of-network healthcare providers.
Plaintiffs allege that MultiPlan and major health insurers worked together to reduce out-of-network reimbursement rates through coordinated pricing practices, shared data, and reimbursement methodologies that lowered payments to providers.
Representing Our Success
Out-of-Network Medical Practices
Who Qualifies?
Out-of-Network Medical Practices
- Primary care & specialist physicians
- Surgeons performing OON procedures
- Physical therapists (APTA named)
- Behavioral / mental health providers
- Chiropractors
Out-of-Network Facilities & Centers
- Emergency departments
- Ambulatory Surgery Centers
- Specialty & urgent care clinics
- Rehabilitation centers
- Behavioral health facilities
Out-of-Network Organizations
- Medical associations (e.g. APTA)
- Independent physician groups
- Multi-specialty practices
ELIGIBILITY CHECK
How to Know If Your Claims Were Affected
Check Your EOB / Remittance Advice
MultiPlan
Claritev
Data iSight
Viant
ProPricer
MARS
- Claims may go back up to 10 years
What Happens Next
No claims list needed
Attorneys obtain a complete MultiPlan claims report on your behalf.
Just confirm exposure
Simply confirm your practice has been exposed to MultiPlan pricing.
Third-party billers help
Billing companies can also help identify affected claims for you.
No risk to your contracts
Filing does not change your legal entitlement to OON payment.
Recent Developments
July 2017
Some claims may be eligible for review going back up to 10 years.
April 2025
U.S. Department of Justice filed a Statement of Interest supporting plaintiffs’ legal theory, confirming coordination through third-party intermediaries like MultiPlan can violate antitrust law.
June 2025
Judge Kennelly denied the defendants’ motion to dismiss. The case is now proceeding to active discovery.
DAMAGES & RECOVERY
What Can Providers Recover?
Fair Market Rate – Amount Paid = Actual Damages × 3 = TREBLE DAMAGES
Example Calculation
Actual damages found: $1,000,000
After trebling (×3): $3,000,000
Providers may seek damages and equitable relief to stop defendants from continuing anti-competitive pricing practices in the OON market.
Key Points
Contingency Fee
No Risk to Future Business Relationships.
Note: Participation does not affect existing out-of-network agreements
No Risk to Contracts
Filing does not affect existing OON agreements.
Option to Sue Separately
You may choose to sue only MultiPlan without naming the insurance companies.
How to Join the Case?
Eligibility Review
Confirm your practice provided OON services since July 2017 and that claims were repriced by MultiPlan or its affiliated tools (Data iSight, Viant, MARS, ProPricer).
Claims Report
File as a DAP
Discovery & Resolution
How Ged Lawyers Can Help
Ged Lawyers brings decades of experience in healthcare reimbursement disputes, and complex litigation against major payors.
We provide:
- Full claims analysis and exposure assessment
- Strategic litigation planning
- End-to-end case management
- National reach with deep industry experience
Frequently Asked Questions
What are providers seeking in this case?
How can I determine if my claims were affected?
Many providers may not realize that MultiPlan pricing was applied to their claims. To assess
exposure, providers should review:
- Explanation of Benefits (EOBs)
- Remittance statements
- Billing records
Common references may include MultiPlan, Data iSight, Viant, MARS, or ProPricer. If a
third-party billing company is involved, they may assist in identifying impacted claims. Claims
may reach back up to ten years, depending on circumstances and insurer involvement. Ged
Lawyers can assist in conducting a comprehensive review of your claims history.
How do I participate in the litigation?
What are the costs?
Will this affect my ongoing payments?
Can I bring claims against MultiPlan only?
What is the MultiPlan Health Insurance Provider Litigation?
What role has the U.S. Department of Justice played in the case?
Who may have been affected by the alleged reimbursement practices?
The alleged impact affects out-of-network healthcare providers, including physicians, surgeons, physical therapists, rehabilitation centers, and other medical professionals who may have received reduced reimbursements for healthcare services.
What damages may be available under federal antitrust law?
Get Started Today
Pursue underpaid claims through healthcare revenue recovery aligned with federal and state reimbursement laws.
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