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An Illinois federal judge on Monday tapped a team of lawyers from to take the lead for plaintiffs in multidistrict litigation accusing MultiPlan and a host of insurers of colluding through the use of the data firm's pricing tools to systematically underpay out-of-network providers.

Napoli Shkolnik Partner 亨特什科尔尼克 was appointed to the executive committee for the direct-action plaintiffs.

Live Well Chiropratice PLLC lauuncher one of the MDL's first lawsuits, alleging that MultiPlan claims its "repricing" tools help insurers determine a fair rate to reimburse providers. But in reality, MultiPlan's services do what they're designed to do: suppress and fix the prices insurers pay physicians.

MultiPlan says its pricing algorithm calculates reimbursement rates based on historical data for similar providers for the same healthcare services, with regional cost-of-living adjustments, the provider said. But behind the scenes, Live Well alleges, MultiPlan overrides the "fair" rate calculated by the algorithm and instead imposes a reimbursement rate selected by MultiPlan and the insurer ahead of time.

MultiPlan and the insurance companies all agreed on the method of pricing the out-of-network claims, to share their competitively sensitive data to help drive the algorithm, and to apply the "override" values, according to the provider's suit. The insurers also agreed to pay providers "what MultiPlan tells them to pay" and to not undercut other MultiPlan customers with competitive pricing, Live Well claims.

Read the original Law360 article in full 这里.

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