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.
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
