Latest news with #reimbursements
Reuters
6 days ago
- Business
- Reuters
US judge rules health insurers, MultiPlan must face price-fixing lawsuits
June 3 (Reuters) - A U.S. judge on Tuesday said healthcare providers can pursue claims that technology provider MultiPlan and a group of insurers conspired to underpay them billions of dollars in reimbursements for out-of-network health services. U.S. District Judge Matthew Kennelly in Chicago ruled, opens new tab that doctors and other providers who filed the proposed class action had plausibly alleged a price-fixing conspiracy that relied on insurers collectively sharing sensitive information with MultiPlan to set reimbursement rates. MultiPlan, which rebranded as Claritev in February, processes payments for out-of-network healthcare services. Major insurers, including defendants UnitedHealth, Aetna and Cigna, have contracts with the company and use its software. In a statement on Tuesday, MultiPlan said it was 'confident in the strength of our legal position' and that the lawsuits have no merit. Aetna parent CVS in a statement said, 'we stand ready to argue the substantive facts of the case and defend ourselves vigorously in this matter.' UnitedHealth and Cigna did not immediately respond to requests for comment. All of the defendants have denied any wrongdoing. Kennelly is presiding over consolidated, opens new tab lawsuits that were first filed in 2023. MultiPlan processes more than 80% of out-of-network claims across the country, or abut 370,000 daily claims, according to the plaintiffs. In a statement, attorneys for the health providers said MultiPlan and the insurance defendants 'orchestrated a cartel through the sharing of competitively sensitive confidential pricing information to illicitly coordinate on out-of-network reimbursements.' MultiPlan and the insurers have argued that health providers are free to reject an insurance company's payment and instead seek full compensation from patients. MultiPlan told the court its services provide industry more flexibility, lowering costs to insurers and patients. Kennelly in his ruling said "whether or not MultiPlan's calculated rates are labeled as 'recommendations,' the plaintiffs plausibly allege that they are more akin to mandates." The U.S. Justice Department submitted a court filing in March backing claims in the health providers' case. The case is In re MultiPlan Health Insurance Provider Litigation, U.S. District Court for the Northern District of Illinois, No. 1:24-cv-06795. Read more: US Justice Department backs medical providers' lawsuit over data analytics software Hospital sues data analytics company MultiPlan in US court antitrust case
Yahoo
23-05-2025
- Business
- Yahoo
Governor Abbott responds to Pfluger's work on securing Texas reimbursements
May 22—WASHINGTON, D.C. — Texas Gov. Greg Abbott released the following statement in response to the $12 billion in border reimbursements for states that stepped up, including Texas, that Congressman August Pfluger (TX-11) and others fought to secure in the One Big Beautiful Bill. "Texas thanks the U.S. House and the Texas Congressional Delegation for including $12 billion in the reconciliation package that will help Texas in its response to the unprecedented illegal immigration in Texas," Abbott said in a news release. "This is a national issue that Texas was proud to address, and we are grateful for the allocation that reduces the financial burden that Texas incurred." "The devastating impact of the previous administration's open border policies has been felt nationwide — but no state has carried the burden more than Texas. Texas spent $11.1 billion on border security, including $5.87 billion on personnel costs and $4.75 billion on border wall and barriers. When the federal government failed to secure our border and protect our communities, Texans stepped up. Throughout my time in Congress, I've fought tirelessly to get our state the reimbursements it's owed, and now, that fight is finally paying off," said Pfluger. Texas had to take on a massive financial burden to protect our communities when the previous administration failed to do so. Throughout his time in Congress, Pfluger has fought to reimburse Texas for securing the southern border, including: — American Border Rescue Plan Act (2021) — This bill would allow state and local governments to use stimulus funds from the American Rescue Plan to cover the costs of border security. — Lone Star Reimbursement Act (2022) — This bill aimed to pay the State of Texas back for the costs of Operation Lone Star incurred in FY21 and FY22, which total $1.43 billion. — Co-led with Rep. Fallon — Letter to President Biden to reimburse Texas/meeting request (2023) — Pfluger-led letter signed by all Republican members of the Texas Delegation — FY24, FY25, and FY26 Appropriations Requests (2023, 2024, 2025) — FY24: Led a letter to the House Appropriations Subcommittee on Homeland Security to reimburse Texas for $5.1 billion. — FY25: Led a letter with 18 signers urging the House Appropriations Subcommittee on Homeland Security to reimburse Texas $11.26 billion. — FY26: Led a letter with 19 signers urging the House Appropriations Subcommittee on Homeland Security to reimburse Texas $11.2 billion. — Efforts to Reimburse Texas through Supplemental Funding Vehicle — Although the measure failed, Pfluger led the charge on including Texas reimbursement through supplemental funding packages in the spring of 2024. — Pfluger has also consigned H.R. 424 and H.R. 1222, and H.R. 3464 to reimburse Texas.
