MultiPlan quashing ‘misperceptions’ on the Hill

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Jul 30, 2024 View in browser   By Ben Leonard and Chelsea Cirruzzo Driving The Day The Senate Finance Committee, led by Sen. Ron Wyden, is investigating whether data analytics firm MultiPlan played a part in the rising price of health care. | Francis Chung/POLITICO 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.   Live briefings, policy trackers, and procedural, industry, and people intelligence from POLITICO Pro Analysis gives you the insights you need to focus your policy strategy this election cycle.  Secure your seat.      Abortion Vice President Kamala Harris is calling for a restoration of Roe v. Wade. | Saul Loeb/AFP via Getty Images RESTORING ROE IS THE GOAL — Vice President Kamala Harris is getting more specific about her pledge to “restore reproductive freedom,” POLITICO’s Megan Messerly and Alice Miranda Ollstein report, calling to bring back Roe v. Wade.  The Harris campaign told POLITICO that the Democratic presidential candidate hasn’t changed her stance since a September interview — backing reviving Roe, which protected abortion until fetal viability, about 22 weeks of pregnancy. Many abortion-rights groups are backing Harris, but some activists have been frustrated about her position and want her to go further than President Joe Biden on the issue of safeguarding abortion rights. The pledge to restore Roe is the latest sign of the more moderate path she is taking as the likely Democratic presidential nominee than what she took in her first bid for office in 2019. Abortion-rights advocates say Roe has been the floor.  “I don’t think there’s a real debate about whether we want to go beyond Roe,” said Mini Timmaraju, president and CEO of Reproductive Freedom for All and who has frequently campaigned for and with Harris. “The debate is what can get done and how quickly it can get done.” Some advocates have called Harris’ stance “unacceptable,” saying Roe hurt patients by allowing states to ban abortion later in pregnancy and imposing other restrictions. “We’re going to be as forceful as we can in making sure our movement is unified in saying that an expansive policy is the only thing we will accept,” said Jenni Villavicencio, an OB-GYN and co-founder of Raven Lab for Reproductive Liberation. In Congress SANDERS’ FUNDING ASK MEETS REALITY — Last year, Senate HELP Chair Bernie Sanders (I-Vt.) and most of the chamber’s Democrats asked for appropriators to double funding for the Older Americans Act, but Sanders’ new ask is significantly lower ahead of a Wednesday markup. The act, which aims to bolster health care and long-term care for older Americans, is up for reauthorization at the end of the fiscal year in September. A significant chunk of the overall funding for the act — initially passed in 1965 under the Great Society programs — goes toward nutrition and food programs. The details: Last spring, Sanders and dozens of Democrats unsuccessfully asked for funding to rise to $4.6 billion for fiscal 2024. For fiscal 2025, Sanders and committee ranking member Bill Cassidy (R-La.) have signed onto a proposal of more than $2.7 billion for fiscal 2025 as part of a five-year package, increasing by 4.6 percent annually. The fiscal 2025 proposal is in line with fiscal 2024 levels. Authorization levels can be higher than what’s ultimately appropriated, as OAA programs received hundreds of millions of dollars less than was authorized in fiscal 2024. Two other Republicans — Sens. Susan Collins of Maine and Markwayne Mullin of Oklahoma — and three Democrats cosponsored the bill. Sanders has pitched significant spending increases for the programs to avert health care spending on issues stemming from malnutrition and falls. Also this week in Congress: The House is out. Senate appropriators are scheduled to mark up their Labor-HHS spending bill Thursday, and a Senate Banking subcommittee will meet to examine banning noncompete agreements Tuesday.   SUBSCRIBE TO GLOBAL PLAYBOOK: Don’t miss out on POLITICO’s Global Playbook, our newsletter taking you inside pivotal discussions at the most influential gatherings in the world. Suzanne Lynch delivers the world's elite and influential moments directly to you. Stay in the global loop. SUBSCRI     Mental Health 988 USE ON THE RISE — The 988 mental health crisis hotline is seeing steadily increasing usage two years after its launch despite low public awareness of the service, a new analysis from KFF found. Before the 988 number went live in July 2022, callers typically reached the crisis hotline by dialing a longer number. Since the shorter number launched, overall contacts and calls to the hotline have nearly doubled, while chats have declined and texts have grown from about 8,300 monthly to more than 98,000 monthly, according to the KFF analysis. KFF polling last year found that fewer than 1 in 5 adults had heard “a lot or some” about 988. The bigger picture: The growth indicates more people may be willing to seek help amid a growing mental health crisis in the U.S. Other findings: Call volume has grown in all states since 988 launched, but the growth rate has varied widely among states. Idaho had the lowest growth rate from 2022 to 2024 at 24 percent, and Oklahoma had the highest at 185 percent. Health Costs FEDS OK N.C. MEDICAL DEBT PLAN — CMS approved North Carolina Gov. Roy Cooper’s plan to use Medicaid to encourage hospitals to eliminate existing medical debt, his administration said Monday. The state’s health department said the Democratic governor’s plan could relieve $4 billion in debt through the elective program, which would offer higher Medicaid payment rates in exchange for relieving various types of medical debt for low- and middle-income people dating to 2014. Hospitals also would have to offer discounts on bills for certain patients to receive the incentives, among a slew of other conditions. Vice President Kamala Harris threw her support behind the program Monday. Zooming out: It’s the latest effort at the state level to address growing levels of personal medical debt. What’s next: The state is working to implement the program. WHAT WE'RE READING Fierce Healthcare takes a look at the top health care lobbying spenders in the second quarter of this year. The Wall Street Journal reports on how law enforcement is attempting to learn who is driving under the influence of cannabis. The Associated Press reports on the FDA approving a new blood test for colon cancer.   Follow us on Twitter Dan Goldberg @dancgoldberg Chelsea Cirruzzo @chelseacirruzzo Lauren Gardner @Gardner_LM Sophie Gardner @sophie_gardnerj Kelly Hooper @kelhoops Robert King @rking_19 Ben Leonard @_BenLeonard_ David Lim @davidalim Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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