Earlier this month, APTA and APTA Private Practice joined the MultiPlan Antitrust Litigation as plaintiffs. This federal antitrust litigation alleges a conspiracy to systematically underpay physical therapists and other health care providers for reimbursements of out-of-network services.
This federal antitrust litigation against MultiPlan, recently rebranded as Claritev, and leading health insurance companies, including UnitedHealth, Elevance (Anthem), Humana, Aetna, Cigna, and various Blue Cross Blue Shield entities, has alleged that they are participating in a coordinated price-fixing conspiracy to increase their profit margins by setting increasingly low reimbursement rates for out-of-network services.
As of 2024, MultiPlan processes more than 80% of all commercial out-of-network reimbursement claims in the United States.
“For too long, physical therapists and their practices have been forced to operate within a payment system that undervalues their expertise and undermines patient access to the high-quality care they provide,” says APTA President Kyle Covington, PT, DPT, PhD. “Anticompetitive and unlawful reimbursement practices are harming our profession, limiting patient choice, and driving up health care costs. This legal action marks a critical step toward fighting against systemic barriers to fair and lawful payment.”
APTA Private Practice President Mike Horsfield, PT, MBA, states, “Physical therapists have been systematically exploited by unlawful pricing schemes that leave us underpaid, overburdened, and legally handcuffed. The era of complacency has ended.” Horsfield goes on to say, “This lawsuit is about holding the bad actors accountable and putting real money back into the hands of those who’ve earned it. Our members are fed up, and so are our patients. We will not back down until we see justice, reform, and the end of these predatory reimbursement practices.”
Convington concludes, “APTA remains unwavering in our commitment to securing fair payment for physical therapist services and advancing a health care system grounded in value, transparency, and patient-centered care.”
An informational webinar discussing opportunities for therapists to sue on an individual basis will be held with the lawyers appointed in the litigation for individual, direct action plaintiffs. All interested members are encouraged to sign up to receive a notification when the webinar date, time, and registration are live.
APTA and APTA Private Practice will provide updates to members as this case progresses.