MultiPlan faces barrage of price-fixing suits in New York
The plaintiffs rely extensively on a New York Times article that ran in April.
A law firm has filed a dozen suits by substance use disorder treatment providers against MultiPlan in the U.S. District Court for the Southern District of New York.
The providers cite allegations in a New York Times article that ran in April about the strategy MuliPlan’s Data iSight program uses to hold down the suggested prices for out-of-network procedures.
The program “is manipulated to generate artificially low payment rates,” according to the version of the complaint filed Friday on behalf of AMS Pro Group, a substance use disorder treatment provider based in Northridge, California.
“MultiPlan’s negotiation services are designed to pressure providers into accepting low payment offers, eliminating the possibility of meaningful negotiation,” AMS Pro adds.
AMS Pro said health insurers previously used a UnitedHealth subsidiary, Ingenix, to reprice out-of-network claims.
The New York state attorney general accused Ingenix of manipulating the price data by including in-network acclaims. The insurers settled with New York by agreeing to pay to start FAIR Health, a new, independent claim database manager, and to refrain from using any alternative to FAIR Health for at least five years.
“The five-year terms of those settlements ended in 2015 and 2016,” according to the AMS Pro complaint. “When those bans lapsed, insurers shifted away from FAIR and began to fix rates again via MultiPlan.”
The complaint lists Aetna, Cigna, UnitedHealth and Elevance Health as co-defendants.
Related: MultiPlan faces another ‘price fixing’ lawsuit, filed by Community Health Systems
Hunter Jay Shkolnik of Napoli Shkolnik, a law firm with a mailing address in Santurce, Puerto Rico, filed the suits.
Shkolnic filed similar complaints on behalf of Hillside Recovery Center, Inspire Recovery Center, MAS Pro Group, Meta Wellness, New Life, Ritz Recovery, Tarzana Recovery Center, The Ohana Retreat, Uplift Recovery Center, Vanity Detox Center and Vanity Wellness Center.
MultiPlan said through a representative that it believes the lawsuit has no merit.
“We look forward to disproving these baseless allegations,” the company said. “MultiPlan plays a vital role in helping to reduce health care costs across the entire health care ecosystem, benefiting payors, providers, employers, and patients.”
The other defendants were not immediately available to comment on the suits.
In the past, health insurers and claim repricing services providers have argued that a tough approach to negotiating prices with providers is important to reining in high U.S. health care spending.
Multiplan’s website. Photo: Monika Kozak/ALM