Old Law, New Tricks: Algorithms and Price-Fixing Cartels in Health Care
This Bulletin is brought to you by AHLA’s Antitrust Practice Group.
- October 06, 2023
- Lisl Dunlop , Axinn Veltrop & Harkrider LLP
- John Bogert , Axinn Veltrop & Harkrider LLP
On August 9, 2023, hospital system Adventist Health System Sunbelt Healthcare Corporation (AdventHealth) filed suit against MultiPlan, Inc. (MultiPlan) in the Southern District of New York, claiming that MultiPlan conspires with commercial payers to underpay out-of-network providers by funneling their claims through its automatic claim-negotiation tool in exchange for a percentage of the discount acquired. This suit comes at a time when government enforcers and private plaintiffs are scrutinizing competitors’ use of common algorithms and information-sharing as potential antitrust violations. How AdventHealth’s case proceeds will provide guidance for payers and providers on the line between joint activities that are efficiency-enhancing and those that violate the antitrust laws.
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