April 29, 2024
NONA TEPPER
A rural health system sued technology company MultiPlan and eight of the country’s largest insurance companies over alleged schemes to strongarm providers into accepting low out-of-network rates.
At issue in the proposed class-action suit are MultiPlan’s repricing tools, which allegedly rely on insurers’ data to deflate their out-of-network reimbursement payments.
MultiPlan acts as an intermediary between insurers and providers to help negotiate pay when a contract does not exist and protect patients from being “balance billed,” or charged the difference between the hospital rate and insurer’s allowed amount.