Health care's heavyweight showdown

A stampede of plaintiffs, including some of the biggest health care and hospital systems in the country, are suing nearly every major health insurance company in America for orchestrating an alleged price-fixing cartel to siphon billions of dollars from care providers and their patients.

The massive legal action involves hundreds of plaintiffs as well as a roster of blue-chip companies, and threatens to upend a lucrative corner of the health sector that determines how out-of-network care is priced and reimbursed for patients with private insurance.

The stakes could hardly be higher for the health insurance industry. The nation’s largest health insurance companies — including five of the 25 largest public companies ranked by revenue — stand accused of conspiring with a third-party software and analytics firm to suppress reimbursement rates for hundreds of millions of patient procedures. The legal complaints suggest potential damages well into the billions, and a ruling in favor of the still-growing list of co-plaintiffs would likely cripple a profit center for the insurance industry built on roughly $200 billion in out-of-network billings each year.

Plaintiffs range from small physician groups and medical associations to some of the most prominent and financially powerful names — Houston Methodist Hospital and The Johns Hopkins Health System, among them — in the health care industry. The flood of suits, filed over the past 18 months in courthouses from New York to San Francisco, are now consolidated before a single federal judge in Chicago.

https://www.bizjournals.com/seattle/news/2025/11/13/health-insurers-hospitals-suit-alleging-cartel.html