AG Kris Mayes sues health insurers over alleged price-fixing scheme

Arizona Attorney General Kris Mayes on Monday sued MultiPlan and eight of the nation’s largest health insurers, accusing them of using a shared computer algorithm to drive down payments to doctors and hospitals while leaving patients with bigger bills.

The lawsuit, filed in Maricopa County Superior Court, names Aetna, Cigna, UnitedHealthcare, Humana, Elevance, Molina, Centene and Health Care Service Corp. alongside MultiPlan, a medical billing data company based in McLean, Virginia.

According to the complaint, the insurers allegedly fed confidential pricing data into MultiPlan’s algorithm, which then recommended how much each company should pay providers. The complaint says the nearly identical, below-market payments happened across the industry, regardless of insurer.

“This case is another example of old-fashioned price-fixing using new technology, but it’s against the law all the same,” Mayes said in a statement.

Mayes is asking the court to stop the practice, order the companies to return money to patients, providers and employers, force them to give up profits from the alleged scheme and impose civil penalties.

Medical groups recently sued over the alleged price fixing

The state’s case is separate from, but echoes claims in, a federal multi-district lawsuit the Arizona Medical Association joined in March. That suit brings together the American Medical Association and hundreds of physician practices nationwide making similar antitrust allegations against MultiPlan and major insurers.

Congress and the Department of Justice started looking at the alleged algorithmic price fixing in 2024.

MultiPlan, which recently changed its parent company’s name to Claritev, processes roughly 360 million claims a year, the attorney general complaint said. The company and its insurer clients account for more than 80% of out-of-network commercial payments nationwide.

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