The heads of two powerful Senate committees want MultiPlan President and CEO Travis Dalton to answer questions how his company negotiates rates for out-of-network charges they say stick patients with "sky-high medical bills."
In a letter sent to the executive May 22, Finance Committee Chair Ron Wyden (D-Ore.) and Health, Education, Labor and Pensions Committee Chair Bernie Sanders (I-Vt.) ask Dalton to meet with Senate aides by June 5 to explain the findings of a recent New York Times investigation into how the ;the data analytics company manages out-of-network charges. The New York Times first reported on the letter Tuesday.
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"Our committees are engaged in ongoing legislative work to put a stop to practices by plan service providers that drive up healthcare costs for consumers while padding their own profits," Wyden and Sanders wrote. “We are concerned that your company’s Data iSight product improperly drives up patient healthcare 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.”
MultiPlan contracts with health insurance companies to settle charges from out-of-network providers and operates a preferred provider organization it leases to insurers. The company maintains its services reduce healthcare spending.
The New York Times published a report last month detailing how MultiPlan and its insurance company and employer customers benefit from offering low reimbursement rates to out-of-network providers that translate into large expenses for patients. The Franklin, Tennessee-based hospital chain Community Health Systems cited the New York Times report in a federal lawsuit it filed against MultiPlan this month.
MultiPlan did not immediately respond to an interview request. The company told the New York Times on Tuesday that it will respond to the senators' inquiry.
Last month, the American Hospital Association called on the Labor Department to investigate MultiPlan, UnitedHealth Group and Cigna in response to the New York Times investigation.
