The Colorado Medical Society (CMS) is closely monitoring a major federal antitrust lawsuit that could have significant financial implications for physicians and health care facilities across Colorado—particularly those who have been paid out-of-network rates by large commercial insurers.

The lawsuit targets MultiPlan—recently rebranded as Claritev—and several of the nation’s largest health insurance companies, including UnitedHealth, Elevance (Anthem), Humana, Aetna, Cigna, and multiple Blue Cross Blue Shield entities. MultiPlan operates under numerous names that may be familiar to physicians, including Data iSight, Viant, NCN, ProPricer, and MARS.

Why this matters to Colorado physicians

The plaintiffs allege that MultiPlan and these insurers engaged in a coordinated price-fixing scheme that systematically suppressed out-of-network payment rates. According to the lawsuit, insurers relied on MultiPlan’s pricing tools to align payments at artificially low levels—potentially costing physicians and facilities billions of dollars nationwide.

Many practices—including those in Colorado—may have unknowingly had claims repriced through MultiPlan’s systems, resulting in lower payments than would have occurred in a competitive market. These impacts may be reflected in Explanations of Benefits or remittance advice, though the involvement of MultiPlan is not always clearly disclosed.

Progress in the case

The litigation has advanced in meaningful ways that CMS views as encouraging for physicians:

• The U.S. Department of Justice filed a statement of interest in March 2025, signaling serious federal concern about the alleged conduct.
• In June 2025, the federal court denied the defendants’ motion to dismiss, allowing the case to move forward into discovery.

These developments suggest the claims are substantial and warrant further scrutiny—an important step toward potential accountability.

Potential financial recovery

Physicians and health care providers who were paid out-of-network by major insurers may be eligible to seek financial damages for claims dating back as far as 10 years. Importantly, providers do not need to wait for a class action ruling to pursue recovery. The court has appointed attorneys to lead individual (non-class) claims, and affected physicians may choose to participate now.

A proposed class action is also moving forward, though a decision on class certification is not expected until 2027.

CMS commitment to defending the profession

CMS is sharing this information as part of our ongoing commitment to defending the economic viability of physician practices and pushing back against unfair payer practices. Whether through advocacy at the Capitol, regulatory reform, or monitoring high-impact litigation like this, CMS works to ensure physicians have the information and support they need to protect their practices.

Physicians who want to learn more or explore whether they may have been affected can access resources and request a free case evaluation from court-appointed counsel at:
https://www.napolilaw.com/en/multiplan/

CMS will continue to keep Colorado physicians informed as this case develops and as opportunities arise to support fair payment and accountability in the health care system.