DOJ Filing Ups the Ante in Price-Fixing Case Against Health Insurers, MultiPlan
-
Apr 04, 2025
The Department of Justice (DOJ) on March 27 filed a statement of interest in a U.S. District Court in Illinois that supported health care providers’ cases against multiple health insurers and MultiPlan, a data analytics firm that offers health care cost management services such as out-of-network claims repricing. The filing suggests that if the court agrees that payers used MultiPlan’s algorithm to collude on suppressing prices paid to providers, such conduct could be considered an antitrust violation, according to Loren Adler, a fellow and associate director at the Brookings Center on Health Policy.
Adler tells AIS Health he is “curious about the DOJ’s motivation” for the filing, but he notes that an ultimate ruling in favor of providers could lead to higher reimbursement and overall health care costs. Adler points out that this is different than other health care antitrust cases the DOJ has pursued, including when payers or hospitals merge and raise prices. In those cases, the plaintiffs and agencies want to have more competition and lower prices.
Read more
© 2024 MMIT
The Latest
Meet Our Reporters
Meet Our Reporters
GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND
Sign up for publications to get unmatched business intelligence delivered to your inbox.