Staff Reports
Attorney General Kris Mayes just filed a big lawsuit in Maricopa County Superior Court accusing MultiPlan — now calling itself Claritev — and eight major health insurers of using a shared algorithm to rig out‑of‑network payments. The complaint says these companies pooled competitive claims data and let a single repricing tool decide how much doctors and hospitals got paid. That’s a serious charge: algorithmic price‑fixing, if true, would mean patients and providers were shortchanged by technology dressed up as efficiency.
The heart of the complaint
The suit names Claritev (formerly MultiPlan) and insurers including Aetna, Cigna, UnitedHealthcare, Humana, Elevance, Molina, Centene and Health Care Service Corporation. Arizona’s lawyers say the defendants sent proprietary payment data into a common engine that spat out the same low reimbursement rates for out‑of‑network care across the board. The state is asking for an injunction to stop the practice, restitution for harmed patients and providers, disgorgement of ill‑gotten profits and civil penalties under Arizona antitrust and consumer‑protection laws.
What the companies say and what’s at stake
Claritev denies the claims and says it complies with state and federal antitrust law. Insurers are disputing the complaint as well. Still, the scale alleged in filings is striking: Claritev processes a huge share of commercial out‑of‑network claims — numbers cited in industry reporting suggest more than 80% of such claims and hundreds of thousands of repriced claims each day. If the complaint’s facts hold up in discovery, this isn’t a small bookkeeping dispute. It could reshape how out‑of‑network reimbursements are set nationwide.
Why conservatives should care — and be skeptical
Conservatives can applaud a crackdown on cartel‑style behavior. Price‑fixing is bad whether it’s done by unions, bureaucrats, or billion‑dollar insurers hiding behind algorithms. But we should also be skeptical about selective enforcement and expanding state power. Critics — including Republican state leaders — have pointed out that the AG is going after private firms while big problems in government programs and state contracting remain under‑investigated. Good governance means treating both public and private waste and fraud the same way, not using a flashy lawsuit as political theater.
The court fight ahead will hinge on documents and expert proof about who built the repricing tool, who controlled the inputs, and whether insurers retained independent decision‑making. This suit plugs Arizona into a wider national fight — federal judges have already let related antitrust claims proceed elsewhere and the Department of Justice has shown interest. Keep an eye on discovery: either the AG has a paper trail proving coordinated conduct, or we’ll learn whether algorithmic tools are being blamed for what may be ordinary contracting choices. Either way, Arizonans deserve clearer prices, fair pay for providers, and accountability — not press releases and selective outrage.
