The Growing Antitrust Risks Of AI Pricing For Health Insurers

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July 22, 2026

The Growing Antitrust Risks Of AI Pricing For Health Insurers

Law360

As algorithmic pricing models continue to gain traction throughout industries, they increasingly face scrutiny from legislators, enforcers and private plaintiffs who fear their anticompetitive potential. The health insurance industry is no exception: Courts are seriously considering challenges to algorithmic models for health insurance pricing, and legislators are also stepping in.

This article focuses on recent legislative and enforcement trends to regulate this developing technology, as well as two ongoing cases involving algorithmic pricing in the health insurance industry, In re: MultiPlan Health Insurance Provider Litigation in the U.S. District Court for the Northern District of Illinois and In re: Zelis Repricing Antitrust Litigation in the U.S. District Court for the District of Massachusetts. Both cases are now in discovery as the plaintiffs continue to pursue their remaining claims.

To continue ready Amy Vegari and Nico Galván's article in Law360, click here.

Firm Highlights

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On Wednesday, July 29, Partner Amy Vegari will speak on a panel at the American Conference Institute's Women Leaders in Life Sciences Law Conference titled "Navigating the New Fraud and Abuse Landscape: Key Trends, Landmark Cases, and Compliance Lessons from the Last Year." Ms. Vegari will join firm alumna Jacqueline Bonneau (Senior Counsel, Commercial Litigation, Johnson & Johnson), Peena Patel (Senior Associate General Counsel, Abbvie), and Lisa Re (Partner, Arnold & Porter) for a discussion examining recent trends in False Claims Act litigation, potential fraud risks for life sciences companies, and the new frontier of enforcement. To learn more, please click here.

Not Over Yet?: Drug Manufacturers Eye Potential Circuit Split on Federal Drug Pricing Program

The Inflation Reduction Act’s Drug Price Negotiation Program has been the subject of litigation since Congress passed it in 2022 in an effort to curb the cost to Medicare of brand-name pharmaceutical drugs. These challenges—initiated in federal court by major pharmaceutical manufacturers—have largely been unsuccessful, rejected in both federal district and appeals courts in the Second and Third Circuits, with writs of certiorari uniformly denied by the U.S. Supreme Court. But all hope is not yet lost for pharmaceutical manufacturers’ opposition to the DPNP. A few challenges remain pending in the U.S. Courts of Appeals for the District of Columbia and Fifth Circuits, with the latter signaling potential receptiveness to the manufacturers’ positions at oral argument. To continue reading Amy Vegari and...

Bankruptcy Court Decides Issue of First Impression Concerning Code Section 365(h)

When a debtor that is a landlord rejects a real property lease in bankruptcy, the tenant has a choice. Either the tenant can treat the lease as terminated or retain its rights under the lease. These rights include the use, possession, quiet enjoyment, subletting, and hypothecation of the property. In a recent case, the parties and the court grappled with this question: when does the tenant need to make that decision? When the lease is rejected, or by some other date? Interestingly, neither the court nor the parties found case law on this issue. It was one of first impression. In re All Star Props., LLC, No. 25-41314, 2026 Bankr. LEXIS 1461 (Bankr. N.D. Ga. June 15, 2026). The debtor owns...

Firm Tops The American Lawyer's 2026 Pro Bono Scorecard with Number 1 Ranking

Patterson Belknap has been recognized with a number 1 ranking in The American Lawyer's 2026 Pro Bono Scorecard. These rankings assess pro bono efforts among Am Law 200 firms and are based on the average number of pro bono hours per lawyer and the percentage of lawyers performing 20 or more pro bono hours in 2025. The Scorecard highlights the firm's “intense focus” on pro bono work, with an average of 185.7 hours per lawyer and 85.1% of firm lawyers doing more than 20 hours of pro bono. The article includes commentary from Pro Bono Chair, Michael F. Buchanan, on the firm’s commitment to both impact litigation and pro bono work that has an impact on people's lives, such as access to health care,...

IRS Clarifies Application of the Non-Profit $1 Million Tax Post-OBBBA

The Internal Revenue Service (“IRS”) released Notice 2026-36 (Notice of Intent to Issue Regulations under Section 4960), (the “Notice”) relating to the tax on executive compensation under Internal Revenue Code (“Code”) Section 4960, as modified by the One Big Beautiful Bill Act (the “OBBBA”). The Notice clarifies the IRS’s interpretation of the changes the OBBBA made to Section 4960. Background Prior to the passage of the OBBBA, Section 4960 of the Code imposed a 21% excise tax on remuneration paid to “covered employees,” which included the top five (5) highest compensated employees of a tax exempt organization (with a “once-in-always-in” rule that swept in any individuals who were previously in the “top five” for tax years beginning after December 31, 2016)....

Regulation E-Delivery: SEC Proposes to Make Electronic Communication the Default

On July 16, 2026, the Securities and Exchange Commission announced a proposed rule to broaden many financial market participants’ use of electronic communications with investors and others who receive information pursuant to federal securities laws.[1] Referred to as “Reg E-Delivery,” the new rule aims to help issuers and others who disseminate SEC-required information transition away from delivering paper documents, a communication method the Agency pointed out imposes “unnecessary costs and expenses” while “no longer reflect[ing] the preference of most investors.”[2] Commenting on the proposed rule, Chair Atkins stated: The world has changed dramatically since many of our rules were first adopted. But, all too often, our regulatory framework has remained static. … In an age of artificial intelligence and blockchain technology, a...