“Nonprofit hospital system AdventHealth has sued data analytics company MultiPlan (MPLN.N) in U.S. court, accusing it of leading a price-fixing conspiracy that underpaid healthcare providers billions of dollars for out-of-network reimbursements from major insurers,” Mike Scarcella writes for Reuters. “Florida-based AdventHealth, which operates 50 hospitals across the U.S. and says it is the country’s largest Protestant hospital system, filed its antitrust lawsuit in Manhattan federal court on Wednesday against MultiPlan, the lone defendant. New York-based MultiPlan markets itself as a cost-management technology provider for commercial health insurers that saves members billions of dollars. A representative for MultiPlan in a statement said the company ‘believes this lawsuit has no merit and looks forward to disproving these baseless allegations.’ AdventHealth’s lawsuit claimed that ‘virtually every commercial healthcare payor’ has agreed to use MultiPlan pricing tools that ‘suppress out-of-network reimbursements paid to healthcare providers.’ MultiPlan, according to the lawsuit, acquires and uses real-time, confidential pricing information from member healthcare insurers to fix reimbursement prices. Healthcare providers such as AdventHealth have no other practical ability but to accept the ‘take-it-or-leave-it’ reimbursement amount that MultiPlan imposes, the lawsuit alleged. AdventHealth’s complaint said annual alleged underpayments to care providers was $19 billion per year.” Mike Scarcella, “Hospital sues data analytics company MultiPlan in US court antitrust case,” Reuters.
Jeanne Pinder is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded... More by Jeanne Pinder
