Zelis, Aetna Accused of Scheme to Suppress Health-Care Payments

Private-equity backed Zelis Healthcare LLC and some of the nation’s largest insurers including Aetna Inc. and Cigna Corp. were sued for allegedly colluding to push down reimbursements for providers’ claims submitted for out-of-network services.

Pacific Inpatient Medical Group Inc., a team of doctors and other health-care professionals, alleged it received “repriced” payments below what it would have absent the conspiracy with Boston-based Zelis, according to a March 28 complaint filed in the US District Court for the District of Massachusetts.

Dennis C. Ayer DDS LLC, a dental practice in Kansas, brought a similar suit Monday against Zelis and the insurers. ...