Patti Sietz-Honig, a video editor at Fox 5 in New York, filed the complaint in 2022. The cost of seeing a specialist for chronic back pain has skyrocketed, and she faces about $60,000 in fees.
Ms. Sietz-Honig pressed for updates about her complaint and was sent articles critical of MultiPlan from the Capitol Forum, a site dedicated to antitrust and regulatory news. Last March, the agency emailed him that his employer and his insurer, Aetna, had agreed to a “temporary exception” and made additional payments.
“Unfortunately,” the agency wrote, the law “does not prohibit the use of third-party vendors” to calculate payments.
Meanwhile, his longtime pain specialist began demanding an upfront payment. To save money, Ms. Sietz-Honig his appointments.
“I’ve been feeling a lot of pain lately,” he said, “so I went — and paid.”
‘Not Real Negotiations’
As MultiPlan became deeply embedded with major insurers, it introduced new tools and strategies that yielded higher fees, and in some cases told insurers what unnamed competitors were doing, documents and interviews show.
After meeting in 2019 with a MultiPlan executive, a UnitedHealthcare senior vice president wrote in an internal email that other insurers were using MultiPlan’s aggressive pricing options more widely, and UnitedHealthcare could catch up.
“Dale didn’t specifically name the competitors but from what he said we got a sense of who’s who,” wrote the executive, Lisa McDonnel, referring to Dale White, then an executive vice president at MultiPlan. He described how Cigna, Aetna and some Blue Cross Blue Shield plans appear to be using MultiPlan.
