Lawmakers are continuing to press for tougher regulations on MultiPlan, the New York Times reported Aug. 21.
The calls come after the Times published an investigation in April alleging MultiPlan helped insurers collect millions in fees.
In a letter published Aug. 20, Reps. Bobby Scott and Mark DeSaulnier asked Lisa Gomez, assistant secretary of the Employee Benefits Security Administration, to provide information on efforts the department has made to address "troubling practices" by MultiPlan and insurers.
MultiPlan helps health plans handle out-of-network claims, advising insurers what to pay providers. In its investigation, the Times alleged plans often pay much less than providers bill — and charge self-funded employers a percentage of the savings as a processing fee. The formula incentivizes insurers to pay providers less so they can charge employers higher fees. Some patients have paid out-of-pocket for the remaining costs, the Times reports.
A spokesperson for Senate Finance Committee Chair Ron Wyden told Politico in July the committee is investigating whether Multiplan acts as a "middleman" driving up prices.
In May, Sen. Amy Klobuchar asked the Justice Department and the Federal Trade Commission to investigate potentially anticompetitive conduct by MultiPlan.
The FTC and DOJ have not contacted MultiPlan, CEO Travis Dalton told Politico.
In addition to Congressional scrutiny, MultiPlan is facing lawsuits from multiple health systems. Franklin, Tenn.-based Community Health Systems, Altamonte Springs, Fla.-based AdventHealth and Shreveport, La.-based Allegiance Health Management have all filed lawsuits alleging MultiPlan is withholding dollars from providers.
The three lawsuits, and lawsuits from three other providers, have been centralized in an Illinois federal court.
A MultiPlan spokesperson told the Times the outlet has "repeatedly misinformed the public about how MultiPlan works."
"MultiPlan's services do not raise patients' overall health care costs, they lower them — including by minimizing or eliminating balance bills for tens of millions of patients — and to state or imply the contrary is false and misleading," the spokesperson said.
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