Arizona Attorney General Kris Mayes announced a lawsuit Monday against MultiPlan, which last year renamed itself Claritev, alleging the company conspired with insurers for years to under pay doctors and hospitals, oftentimes leaving patients footing the bill for out-of-network care.

“This wasn’t an accident,” Mayes told reporters Monday. “It was a coordinated deliberate scheme.”

Mayes’ office is accusing Multiplan, along with insurers Aetna, Cigna, UnitedHealthcare, Humana, Elevance, Molina, Centene and Health Care Service Corporation, of working together to determine lower rates for out-of-network care.

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The sprawling complaint alleges that MultiPlan helped these companies set the prices for out-of-network services by using a proprietary algorithm that fixed prices for each service regardless of the geographic area or other factors.

The company has already been under the microscope after a 2024 investigation by the New York Times brought many of the same allegations to light. The company is also facing a federal lawsuit making similar allegations in which the U.S. Department of Justice has sided with those seeking relief from MultiPlan.

“This case, like the RealPage case, is an example of old fashioned price fixing using new technology which is against the law all the same,” Mayes said, referring to a lawsuit she filed in 2024 involving collusion among apartment complex owners.

The MultiPlan lawsuit alleges that insurers contributed to the “illegal repricing scheme by supplying the claims, and billing data that informs MultiPlan’s algorithms, which would be against each client-payor’s competitive economic interests but for the market control on out-of-network services compensation rates affected by the conspiracy.”

Mayes’ office is seeking a permanent injunction from MultiPlan being allowed to operate in this way; restitution for those harmed; civil penalties; and for those named in the suit to surrender any profits made under the alleged “illegal scheme.” State prosecutors claim that MultiPlan and its co-conspirators violated Arizona’s anti-trust act consumer fraud act.

“The more they squeezed our doctors and hospitals, the more profits they made,” Mayes said.

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The lawsuit alleges that MultiPlan and the health insurers wielded an outsized influence, effectively eliminating any competition and consolidating market power — allowing them to set prices and “effectively forming a buyer’s ‘cartel.’”

This “cartel” primarily impacted PPO plans, specifically those through employers which are offered as having increased flexibility.

The availability of a large network of insurers and their data was something that MultiPlan used to “further lower out-of-network prices and to enlist new clients into the cartel,” the lawsuit alleges.

“MultiPlan retains all competitor data in a massive database—by February 2026, MultiPlan touted that it had ‘approximately 15 petabytes of data’—to which all clients have access,” prosecutors wrote in the lawsuit.

And that data allowed MultiPlan to create tools like PlanOptix, which allowed any member of that “cartel” to determine in real time if a competitor was reimbursing at a higher or lower rate than them.

“As a doctor, there is nothing more frustrating or heartbreaking than watching an insurance plan get in the way of a patient’s needs,” Dr. Andrew Carroll told reporters Monday. Carroll supported the lawsuit and said that MultiPlan’s alleged price fixing hurts smaller independent doctors like him, as they are unable to appeal decisions made by the company.

Doctor and Arizona Medical Association President Jason Jameson said that the “collusion” among insurers created a dangerous environment for patients in the state, in addition to harming physicians and hospitals.

“It is more than insulting, it is actually dangerous to the healthcare in our state,” Jameson said.

With hospitals set to see major impacts to their budgets from Medicaid and Medicare cuts, MultiPlan and the insurer’s “collusion” creates further problems for hospitals that oftentimes rely on insurance payouts, Mayes said.

“The MultiPlan cartel takes particular advantage of hospital emergency departments,” the lawsuit alleges. “Emergency rooms cannot decline to treat patients with insurance plans connected to MultiPlan. As such, hospital emergency rooms rely on the commercial insurance networks that contract with MultiPlan for reasonable compensation for emergency services. At the same time, demand for emergency department medical services is highly inelastic. Patients often have little choice regarding which hospital they are taken to and are rarely able to avoid or defer emergency medical treatment. By colluding to underpay emergency services providers, MultiPlan and its clients have been bleeding emergency rooms dry.”

The lawsuit also alleges that private medical groups with tight profit margins are being hit hard by these underpayments.

“While revenue per physician has increased by 9.1% since 2020, the median expense per physician has increased by 26.5%,” the lawsuit says. “Just like other providers, these medical groups cannot afford to be underpaid. When they are, access to and the quality of care could decline, which, in turn, harms patients.”

Claritev, the new name for MultiPlan, did not respond to a request for comment for this story.