Allegiance Health Antitrust Suit Claims Out-Of-Network Algorithm Collusion

Allegiance Health Management, a Louisiana -based health system, is suing MultiPlan, Inc., which both operates as an insurer, and contracts with other health plans to reprice and process out-of-network claims rather than reimburse at the “usual and customary” rate. Allegiance alleges that, starting in 2017, MultiPlan colluded with other health plan payers to reduce reimbursement to out-of-network provider organizations by up 39%. By 2022, MultiPlan had used its repricing tools to reduce reimbursements for 370,000 out-of-network claims daily for more than 700 payers. As a result, Allegiance has been underpaid by $22.9 . . .