MULTIPLAN MAKES ITS CASE — Data analytics company MultiPlan is working to clear its name on Capitol Hill after coming under scrutiny amid allegations that it colludes with health insurers, POLITICO’s Kelly Hooper reports. Following demands for answers from Congress, MultiPlan CEO Travis Dalton met with Senate staffers over the past several weeks to defend the company and show how it uses publicly available data to recommend how much providers should be paid for out-of-network care. “We’ve got a lot to say about our company and the role we play, and we think the meetings have gone well to this point,” Dalton said. “I think that they understand the industry better.” Why it matters: MultiPlan’s meetings as Congress considers increasing transparency in health care pricing. Dalton’s explanation — that his company merely provides data and analytics services to employers and insurers — underscores the complexities of health care payments in a system that pits providers against insurers, with patients occasionally caught in the middle. Background: The chairs of the Senate Finance and Health, Education, Labor and Pensions committees requested meetings with MultiPlan after a New York Times investigation in April showed how the company, which contracts with employers and health insurers, has a financial incentive to recommend insurers reimburse providers less for out-of-network care: The bigger the savings MultiPlan can secure for the employer, the bigger the fee MultiPlan and the insurer receive. That sometimes means patients are left on the hook for the remaining cost. Finance Chair Ron Wyden (D-Ore.) told POLITICO the committee is exploring whether MultiPlan is another “middleman” driving up costs for patients. Senate Finance staff have discussed this concern with MultiPlan “and continue to seek answers about how and why these expenses are occurring,” a Wyden spokesperson said. Sen. Amy Klobuchar (D-Minn.), who sent a letter in April urging the FTC and the DOJ to investigate MultiPlan’s potentially anticompetitive behavior, sponsored legislation earlier this year that would prevent companies from using algorithms to fix prices. “Price fixing is illegal under our antitrust laws, but algorithmic pricing tools may exploit loopholes in current law that could be used to illegally raise prices on everything, including health care costs,” Klobuchar said Monday in a statement. Her legislation has not made it out of committee, and neither the DOJ nor the FTC has contacted the company, Dalton said. Both agencies declined to comment. MultiPlan’s response: Dalton, who started at the company in March after leading health care data company Oracle Health, said the narrative that MultiPlan is saddling patients with surprise bills is misleading. “We’ve been addressing a lot of the misperceptions about MultiPlan and the role we play,” Dalton said after meetings with the two Senate committees. “There are different levels of knowledge across the Hill, but everyone has given us the courtesy of listening to us on how the industry works and how MultiPlan is an important part of it, including dispelling some of the narratives that just aren’t true. …” WELCOME TO TUESDAY PULSE. Your host just moved to Alexandria from D.C. — and is all ears for restaurant recommendations at bleonard@politico.com. Send me or Chelsea (ccirruzzo@politico.com) your tips, news and scoops. Follow along @_BenLeonard_ and @ChelseaCirruzzo.
| 
No comments:
Post a Comment