NY Times Investigation Exposes Multiplan & Insurer's Hidden Financial Incentive Practices

Last Sunday the New York Times published two articles written by journalist Chris Hamby, regarding Multiplan and the major health insurance companies. His investigation exposed the “Percentage of Savings Model”, used by Multiplan and insurers that incentivizes the parties to under-reimbursement out-of-network claims to yield higher fees for themselves:

Insurers Reap Hidden Fees by Slashing Payments. You May Get the Bill.
In Battle Over Health Care Costs, Private Equity Plays Both Sides

Mr. Hamby also published a corresponding explainer video to further illustrate the model:

Insurers Earn More When Less of an Out-of-Network Claim Gets Paid

For more than 12 years, Cohen Howard has been challenging underpayments raising many of the issues cited in these articles. Having a major news organization corroborate our own dealings with the payors while putting a spotlight on these abuses is validating.

For those compared been in the industry, Mr. Hamby compares the current Multiplan scenario to the United HealthCare/Ingenix investigation from nearly 15 years ago. Our firm maintains that the facts described in the article are even more egregious than those discovered in the United HealthCare/Ingenix case.

Our firm has several pending cases filed with litigation counsel against payors seeking class action certification over the issues raised in the articles, along with several other filed cases against Multiplan. We are hopeful now with this broad public exposure that consideration in resolving these matters will be given to secure additional reimbursements rightfully owed to our clients.

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Notable Cases

Class Action v. CIGNA Corporation

Corporation et al, Case No. 3:22-cv-00769-OAW, District of Connecticut (New Haven). Date Filed: 06/10/2022.

Lawsuit v. Multiplan, Inc.

et al, Case No. 1:21-cv-02421-LLS, Southern District of New York (Foley Square). Date filed: 03/19/2021.

Class Action v. UnitedHealth Group Incorporated

Incorporated et al, Case No. 1:22-cv-10756-VEC, Southern District of New York (Foley Square). Date Filed: 12/21/2022.

Lawsuit v. Multiplan, Inc.

Inc. et al, Case No. 1:20-cv-10685-LLS, Southern District of New York (Foley Square). Date filed: 12/18/2020.

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