Minnesota Sen. Amy Klobuchar is calling on the Justice Department and the Federal Trade Commission to investigate potentially anticompetitive conduct by data analytics firm MultiPlan.
Ms. Klobuchar's call for a probe comes after The New York Times reported major insurers made millions in fees by using MultiPlan to determine how much to pay providers for out-of-network claims. MultiPlan is also facing lawsuits over alleged pricing fixing from Shreveport, La.-based Allegiance Health Management and Altamonte Springs, Fla.-based AdventHealth.
"While it is common for patients to pay different rates for out-of-network care, I am concerned that — rather than competing for business from employers by reducing these costs to employees — algorithmic tools are processing data gathered across numerous competitors to subvert competition among insurance companies," Ms. Klobuchar wrote in her April 29 letter to Justice Department and FTC leaders. "The result is that instead of competing with each other, insurance companies are pushing additional hidden costs onto employees and patients."
She said she is encouraging the entities to "investigate the use of algorithms that collect and process data in the out-of-network insurance payment industry to determine payments for physicians and out-of-pocket costs for patients to determine whether any of this conduct violates the law."
MultiPlan declined to comment on Ms. Klobuchar's call for an investigation.