March 28, 2025: Hartley LLP filed the first and proprietary case against Zelis and health insurers for creating a conspiracy to fix and artificially suppress prices of healthcare services paid to healthcare providers for performing “out-of-network” healthcare services. The cost of health insurance to consumers in the United States has risen dramatically in recent years, particularly since 2016, following the conclusion of the FAIR Health exclusive use period. Upon the expiration of FAIR Health exclusivity, Zelis and its predecessor companies began providing repricing services for insurance companies and other commercial payers of healthcare services to the detriment of providers who provide healthcare services outside of those payers’ networks. Doctors, dentists, chiropractors and other healthcare professionals were faced payment amounts from Zelis — working on behalf of over 700 insurance companies — worth as little as 1% of the providers’ invoiced amount. Hartley LLP represents a nationwide putative class of healthcare and dental providers whose invoices for out-of-network care were repriced by Zelis and paid by insurers and other payers in violation of United States antitrust laws.
