Letter to Health Data Company from Finance and HELP Committee Chairs Seeks Details on Business Practices that Increase Americans’ Medical Bills
Washington, D.C. – Senate Finance Committee Chair Ron Wyden, D-Ore., and Senate Health, Education, Labor and Pensions (HELP) Committee Chair Bernie Sanders, I-Vt., asked data analytics company MultiPlan to meet with the committees and explain the company’s role in negotiating out-of-network payments on behalf of employer-sponsored health plans, which news reports indicate often results in higher costs for patients.
“While this practice is advertised as a way to constrain health care costs, recent reporting reveals that this practice often dramatically reduces plan payments for out-of-network services and leaves patients with sky-high medical bills that they are on the hook for paying,” Wyden and Sanders wrote. “We are concerned that your company’s Data iSight product improperly drives up patient health care costs and, further, that the financial incentives built into the fee for the use of the Data iSight product result in an improper conflict of interest between determining a plan’s liability for out-of-network claims and the plan’s duty to provide promised benefits pursuant to ERISA.”
The letter outlines how, according to reports, MultiPlan works to negotiate rates paid by insurance companies to health providers for out-of-network services, and takes a fee that is a percentage of any savings to the insurance company. This fee structure incentivizes MultiPlan to negotiate the lowest possible payout by the insurance company, which in turn shifts costs onto patients.
The letter can be found here.