Data iSight Lawsuit: MultiPlan Hub-and-Spoke Price-Fixing Claims

The Data iSight lawsuit is a sprawling federal antitrust action accusing MultiPlan — now rebranded as Claritev — and the country’s largest health insurers of using the Data iSight pricing algorithm to fix out-of-network reimbursement rates far below market. Consolidated as MDL No. 3121 in the Northern District of Illinois, the case survived a motion to dismiss in June 2025 and is now in discovery, with the first bellwether trial scheduled for December 7, 2027.¹

What Data iSight Does and Why Providers Say It’s Rigged

Data iSight is MultiPlan’s proprietary tool for calculating what insurers should pay for out-of-network medical services. For practitioner claims it generates “median reimbursement levels” from aggregated claims data; for facility claims it uses a “cost-up approach.” MultiPlan has marketed the algorithm as producing savings of 61 to 81 percent off billed charges.²

Providers say the tool is not the neutral pricing engine it’s sold as. The American Medical Association’s complaint alleges that Data iSight leans on flawed inputs, including discounted in-network rates that are inherently lower because of negotiated volume agreements, and that insurers can enter “overrides” telling the system not to pay more than a set percentage of the Medicare rate. Those suppressed payments then feed back into the database, dragging future calculations lower still.³

Testimony from a 2021 Nevada jury trial involving UnitedHealthcare bore this out. A MultiPlan executive testified that Data iSight “produces an amount” and then “any other client or operational overrides are applied,” and a retired UnitedHealth executive described a 2019 override that dropped a specific emergency care payment from $609.28 to $435.20.⁴

The Alleged Hub-and-Spoke Scheme

The antitrust theory is straightforward. MultiPlan is the “hub,” major insurers are the “spokes,” and instead of competing on what they pay out-of-network providers, the insurers outsource that function to MultiPlan and feed it their proprietary claims data. MultiPlan uses the pooled information to generate standardized, below-market rates that participating insurers then adopt.⁵

The AMA calls this arrangement the “MultiPlan Cartel” and alleges it involves roughly 700 of the approximately 1,100 health insurers in the country, including all 15 of the largest.³ Named insurer defendants across the consolidated actions include UnitedHealth Group, Elevance Health, Aetna, Cigna, Humana, Health Care Service Corporation, and various Blue Cross Blue Shield entities.⁶

Plaintiffs zero in on MultiPlan’s fee structure as the motive. The company earns a percentage of the difference between the provider’s original charge and the reduced amount the insurer pays, so MultiPlan profits more when providers get paid less. Insurers also collect “shared savings” fees from the employers who fund health plans, meaning both the middleman and the insurer have a financial stake in paying providers as little as possible.³ AdventHealth’s complaint alleged that providers accept MultiPlan’s imposed rate for out-of-network inpatient services 99.4 percent of the time.⁷

Who Is Suing and Who Has Been Sued

The first major complaint came in August 2023, when AdventHealth, a Florida-based nonprofit hospital system running 50 hospitals across nine states, sued MultiPlan in the Southern District of New York. The complaint alleged roughly $19 billion in annual provider underpayments by 2020 and cited a representative example in which a $15,041.36 claim was cut to $1,131.63, a 92.5 percent reduction.⁸

Others followed quickly. Allegiance Health Management of Shreveport, Louisiana, filed in 2024. The AMA and the Illinois State Medical Society sued in October 2024. The California Medical Association joined later that year, and the Association of New Jersey Chiropractors came aboard in January 2026.⁹¹⁰ By mid-2026 the MDL had consolidated more than 100 provider lawsuits, including a June 2, 2026 complaint from Lifepoint Corporate Services.¹¹

The litigation is structured as a multidistrict litigation, not a traditional class action, so each provider’s case is evaluated individually even though pretrial proceedings are consolidated.¹ A separate class action has been proposed, but a class certification ruling is not expected until 2027.¹²

What the Court Has Ruled So Far

On August 1, 2024, the Judicial Panel on Multidistrict Litigation centralized the cases in the Northern District of Illinois before Judge Matthew F. Kennelly.¹³

The pivotal ruling came in June 2025, when Judge Kennelly denied the defendants’ motions to dismiss the federal and state antitrust claims and the state consumer protection claims. The court granted dismissal only of the direct-action plaintiffs’ unjust enrichment claims.¹⁴ Several parts of the ruling matter for how the case moves forward:

On antitrust standing, the court held that healthcare providers are the direct victims of the alleged conspiracy because balance-billing restrictions prevent patients from being the directly injured party.
On price fixability, the court rejected the argument that out-of-network reimbursement rates are not “prices” that can be fixed.
On algorithmic price-fixing, Judge Kennelly wrote that “an agreement to fix prices within a below-market range through use of an algorithm is no different for antitrust purposes than an agreement to fix prices to a single point.”
On the hub-and-spoke theory, the court found it plausible that MultiPlan’s statements about its ability to “align” rates across clients made insurers aware of a broader horizontal agreement, and that the sharing of competitively sensitive pricing information served as a “plus factor” supporting the inference of conspiracy.

The U.S. Department of Justice filed a Statement of Interest on March 27, 2025, supporting the plaintiffs’ legal theory.¹⁵ MultiPlan later disclosed in a May 2026 SEC filing that it had received a grand jury subpoena from the DOJ’s Antitrust Division in August 2024, indicating an active criminal investigation running alongside the civil case.¹¹

Not every court has agreed. A 2021 lawsuit by the Verity Health liquidating trust in California was dismissed in 2024, with the court ruling that reimbursement rates are not “prices” that can be fixed under the state’s Cartwright Act. A federal case brought by Long Island Anesthesiologists in New York was dismissed in 2025 for failure to plausibly allege antitrust injury. Both dismissals are on appeal.¹⁶

The Money at Stake

The alleged damages are enormous. Plaintiffs say that by 2020 MultiPlan processed approximately $106 billion in out-of-network charges, roughly 81.5 percent of the commercial out-of-network market, and handled more than 370,000 claims per day.¹⁷ AdventHealth’s complaint pegged annual underpayments at $19 billion in 2020. Allegiance Health Management’s complaint put the figure at $22 billion by 2022.¹⁶ Plaintiffs have cited $6.4 billion in suppressed payments for the third quarter of 2024 alone.

Federal antitrust law entitles successful plaintiffs to treble damages, tripling any proven losses. That puts potential exposure in the tens of billions. For scale, a previous antitrust case against Blue Cross Blue Shield resulted in a $2.8 billion settlement.¹⁷

Arizona and Zelis: Related Fronts

The MDL is not the only proceeding. On June 1, 2026, Arizona Attorney General Kris Mayes filed a state-court lawsuit in Maricopa County Superior Court against MultiPlan and eight insurers — Aetna, Cigna, UnitedHealthcare, Humana, Elevance, Molina, Centene, and Health Care Service Corporation — alleging violations of the Arizona Uniform State Antitrust Act and the Arizona Consumer Fraud Act. The state alleges insurers misrepresented the value of PPO coverage while concealing that a third-party algorithm was determining provider payments, and that scheme members could monitor competitor reimbursement rates in real time using a tool called “PlanOptix.”¹⁸¹⁹ Arizona is seeking a permanent injunction, restitution, disgorgement of profits, and civil penalties.

A parallel federal case in the District of Massachusetts targets Zelis, a MultiPlan competitor that uses similar repricing tools. In re Zelis Repricing Antitrust Litigation involves providers from California, New Jersey, Wisconsin, and Kansas suing Zelis alongside Aetna, Cigna, Elevance, Humana, and UnitedHealth Group. On March 30, 2026, Judge Brian E. Murphy denied the defendants’ motion to dismiss, finding the hub-and-spoke allegations could constitute antitrust violations.²⁰

MultiPlan’s Response and Rebrand

In February 2025, MultiPlan announced it was rebranding to Claritev, with shares beginning to trade under the ticker CTEV on the New York Stock Exchange on February 28, 2025. CEO Travis Dalton framed the change as reflecting the company’s evolution into a broader “health tech” firm.²¹ The rebrand did not change its offerings.²²

The company maintains the lawsuits are without merit. In response to the Arizona suit, Claritev called the allegations meritless and said it adheres to all state and federal laws.¹⁹ The company argues its data-driven model helps reduce costs for patients and employers, and Dalton has pointed to dismissals of similar suits as evidence the claims lack foundation.²²

Where the Case Stands Now

As of mid-2026, the federal MDL is in active discovery following the June 2025 denial of the motion to dismiss. The court has appointed separate legal teams to manage the class and non-class tracks.¹² Providers pursuing individual, non-class claims do not need to wait for the class certification ruling expected in 2027, and may be eligible for damages on claims dating back up to ten years. The first bellwether trial is scheduled for December 7, 2027.¹ The DOJ’s criminal investigation, confirmed by the grand jury subpoena disclosed in May 2026, remains ongoing, and new plaintiffs continue to join the MDL.

1
PBG Law. MultiPlan Out-of-Network Underpayment Litigation, MDL 3121
2
MultiPlan. Data iSight
3
U.S. District Court for the Northern District of Illinois. American Medical Association v. MultiPlan, Complaint
4
The Capitol Forum. MultiPlan’s Independent Prices Can Be Set by Insurers
5
Fierce Healthcare. AMA Leads New Antitrust Lawsuit Against MultiPlan and Price-Fixing Cartel
6
Michigan State Medical Society. MultiPlan Antitrust Litigation Update
7
Fierce Healthcare. MultiPlan’s Contracts Are Mafia Enforcer for Insurers, AdventHealth Alleges
8
Business CCH/ALD. Adventist Health System Sunbelt Healthcare Corp. v. MultiPlan, Complaint
9
California Medical Association. CMA Joins Lawsuit Against MultiPlan
10
Association of New Jersey Chiropractors. ANJC Joins Lawsuit Against MultiPlan
11
Insurance Business Magazine. Hospital Giant Lifepoint Sues MultiPlan, Aetna, Cigna Over Alleged Pricing Cartel
12
Medical Society of the State of New York. MultiPlan Antitrust Litigation Update
13
Judicial Panel on Multidistrict Litigation. MDL-3121 Transfer Order
14
Fierce Healthcare. Judge Denies MultiPlan, Payers’ Motions to Toss Price-Fixing Litigation
15
U.S. Department of Justice, Antitrust Division. Statements of Interest
16
Becker’s Payer Issues. What to Know About MultiPlan’s Litigation Saga
17
HFMA. The Latest on Providers’ Landmark Antitrust Suit
18
Arizona Attorney General. Attorney General Mayes Sues MultiPlan and Major Health Insurers
19
Arizona Mirror. Arizona Sues MultiPlan, Major Insurers
20
GovInfo. In re Zelis Repricing Antitrust Litigation, Memorandum and Order
21
Nasdaq. MultiPlan Enters New Era and Unveils New Brand Claritev
22
Fierce Healthcare. MultiPlan Unveils Rebrand