By Mike Scarcella

June 3 (Reuters) - A U.S. judge on Tuesday said healthcare providers can pursue claims that technology provider MultiPlan and a group of insurers conspired to underpay them billions of dollars in reimbursements for out-of-network health services.

U.S. District Judge Matthew Kennelly in Chicago ruled that doctors and other providers who filed the proposed class action had plausibly alleged a price-fixing conspiracy that relied on insurers collectively sharing sensitive information with MultiPlan to set reimbursement rates.

MultiPlan, which rebranded as Claritev in February, processes payments for out-of-network healthcare services. Major insurers, including defendants UnitedHealth, Aetna and Cigna, have contracts with the company and use its software.

In a statement on Tuesday, MultiPlan said it was “confident in the strength of our legal position” and that the lawsuits have no merit.

Aetna parent CVS in a statement said, “we stand ready to argue the substantive facts of the case and defend ourselves vigorously in this matter.”

UnitedHealth and Cigna did not immediately respond to requests for comment. All of the defendants have denied any wrongdoing.

Kennelly is presiding over consolidated lawsuits that were first filed in 2023.

MultiPlan processes more than 80% of out-of-network claims across the country, or abut 370,000 daily claims, according to the plaintiffs.

In a statement, attorneys for the health providers said MultiPlan and the insurance defendants “orchestrated a cartel through the sharing of competitively sensitive confidential pricing information to illicitly coordinate on out-of-network reimbursements.”

MultiPlan and the insurers have argued that health providers are free to reject an insurance company’s payment and instead seek full compensation from patients. MultiPlan told the court its services provide industry more flexibility, lowering costs to insurers and patients.

Kennelly in his ruling said "whether or not MultiPlan's calculated rates are labeled as 'recommendations,' the plaintiffs plausibly allege that they are more akin to mandates."

The U.S. Justice Department submitted a court filing in March backing claims in the health providers' case.

The case is In re MultiPlan Health Insurance Provider Litigation, U.S. District Court for the Northern District of Illinois, No. 1:24-cv-06795.

Read more:

US Justice Department backs medical providers’ lawsuit over data analytics software

Hospital sues data analytics company MultiPlan in US court antitrust case

(Reporting by Mike Scarcella)