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Zelis facilitating illegal suppression of out-of-network payments to healthcare providers, US complaint claims

( March 28, 2025, 23:31 GMT | Official Statement) -- MLex Summary: Zelis Healthcare, UnitedHealth Group, Elevance Health, Aetna and The Cigna Group face US claims accusing them of conspiring to suppress out-of-network payments to healthcare providers, including both medical and dental providers. “The conspiracy at issue concerns the unlawful agreement, communication, coordination, and information sharing associated with collusively depressing and setting payments for out-of-network healthcare services, euphemistically known as ‘repricing.’ Even if neutral sounding, such ‘repricing’ is not based on any pre-payment, provider-payer negotiation, and goes only one direction: down,” the complaint alleges. See attached file. ...

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