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AdventHealth, a large religious-affiliated hospital system, has sued MultiPlan, alleging the company has worked with health insurers to create a “cartel” that systematically underpays hospitals and doctors for care that is delivered out of an insurance company’s network.

AdventHealth claims it has “overwhelming direct evidence” that MultiPlan’s agreements with health insurance companies are anticompetitive, and that MultiPlan’s “multi-year, ongoing conspiracy” with insurers has shortchanged hospitals and doctors at least $19 billion per year. MultiPlan said in a statement it “believes this lawsuit has no merit and looks forward to disproving these baseless allegations.”

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The lawsuit pours fresh gasoline on the fraught relationships between hospitals and insurance companies. It also adds to the ongoing debate about how much providers should be paid if they don’t agree to be part of an insurance network.

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