Overview
- Attorney General Kris Mayes filed the complaint Monday in Maricopa County Superior Court naming MultiPlan (now Claritev) and eight large insurers and asking for a permanent injunction, restitution to harmed parties, disgorgement of profits and civil penalties.
- The complaint alleges insurers relied on a common, AI-driven pricing algorithm and shared confidential claims payment data through MultiPlan to set below‑market out‑of‑network rates and then fed insurer acceptance of low offers back into the model.
- Prosecutors say the system generated geographic‑insensitive, consistently low reimbursements — citing an internal figure that the pricing tool produced $6.4 billion in insurer reductions in Q3 2024 and that MultiPlan earned a share of those underpayments.
- The suit highlights patient and provider harm, saying PPO holders face higher out-of-pocket bills and that small, rural and emergency providers have been underpaid to the point of straining practices and access to care.
- Defendants deny wrongdoing and plan to defend themselves while the case joins existing investigations and litigation that include prior reporting and a federal matter with DOJ involvement, making discovery and regulatory action likely next steps.