Last week the Texas Medical Association joined a federal antitrust lawsuit against MultiPlan — recently rebranded as Claritev. The story being told is doctors versus insurers, an unlawful cartel, $19B in alleged underpayments. It's a clean story. The moment you look at the actual fee math from the complaint, it falls apart.

In this episode I walk through MDL 3121, the $1,000 → $200 cascade, the DOJ's March 27 Statement of Interest backing the plaintiffs' antitrust theory, and what self-funded employers should be asking their TPA on Monday morning. The bellwether trial isn't until December 7, 2027 — three years of fees away.

About 42% of what the algorithm calls "savings" never makes it to the plan. That's not a doctors-vs-insurers story. It's a third-character story.

▶ Watch the video version: https://youtu.be/H3TQUxJt2Xo 📝 Read the written deep dive (full fee math, sources, 3-question employer checklist): https://danmccoymd.substack.com/p/nobody-in-the-multiplan-lawsuit-is

SOURCES MENTIONED

• AMA on the litigation: https://www.ama-assn.org/health-care-advocacy/judicial-advocacy/health-insurance-price-fixing-real-and-ama-fighting-it
• TMA press release: https://www.texmed.org/Template.aspx?id=67699
• DOJ Statement of Interest coverage: https://www.jdsupra.com/legalnews/doj-adopts-aggressive-stance-against-4076897/
• NYT investigation summary: https://whatleykallas.com/nyt-investigation-shows-how-health-insurers-use-multiplan-to-reduce-payments-to-medical-providers-to-iincrease-their-fees-and-profits-at-the-expense-of-patients/
• Capitol Forum on MultiPlan billing incentives: https://thecapitolforum.com/provider-shows-how-multiplan-incentivizes-him-to-raise-his-billing-rate-multiplan-says-it-does-not-encourage-providers-to-overcharge/
• Seattle Times reprint: https://www.seattletimes.com/nation-world/insurers-reap-hidden-fees-by-slashing-payments-you-may-get-the-bill/
• KFF on 2026 small group premiums: https://www.kff.org/health-costs/how-much-and-why-premiums-are-going-up-for-small-businesses-in-2026/
• Medscape Physician Compensation Report 2025: https://www.medscape.com/slideshow/2025-compensation-overview-6018103

LEGAL DISCLAIMER This episode covers public reporting and pending litigation. All allegations are unproven and may ultimately be rejected in court. MultiPlan, Claritev, and the named insurers deny wrongdoing. Nothing here is legal, financial, or medical advice.

Full sources and the deep dive: danmccoymd.substack.com