House Leaders Seek Information on DOL Efforts to Protect Workers from Self-Dealing by Health Plan Service Providers

08.20.24

House Leaders Seek Information on DOL Efforts to Protect Workers from Self-Dealing by Health Plan Service Providers

Companies, such as MultiPlan, have been found to raise costs for hard-working Americans.

WASHINGTON - Today, House Committee on Education and the Workforce Ranking Member Robert C. "Bobby" Scott (VA-03) and Health, Employment, Labor, and Pensions Subcommittee Ranking Member Mark DeSaulnier wrote to the Department of Labor (DOL) Employee Benefits Security Administration (EBSA) Assistant Secretary Lisa M. Gomez regarding recent reports of opaque and self-dealing compensation practices by service providers of employer-sponsored health plans. As revealed in a recent New York Times investigation, companies, such as a private-equity backed data analytics firm called MultiPlan, have been accused of business practices that harm hard-working Americans, employers, and health care providers.

"To assist in [oversight of service provider fees], Congress has worked in a bipartisan manner to increase transparency through legislation such as the Consolidated Appropriations Act, 2021 (CAA) which specified … disclosures [that] are necessary to determine the reasonableness of fees and to identify conflicts of interest that can lead to higher costs for both workers and employers" the Members wrote.

"Regrettably, opaque fee structures and alleged self-dealing are pervasive, and have resulted in several recent lawsuits brought on behalf of employers and plan participants who are harmed by higher health care costs, said the Members. "In addition, it remains unclear the extent to which service providers-including [third-party administrators] and pharmacy benefit managers-are providing meaningful disclosures of their direct and indirect compensation, as required under the CAA."

The request comes as part of committee efforts to lower health care costs and deliver transparency for Americans. However, without prompt action by Congress, DOL faces a funding cliff in December when funding provided through the No Surprises Act Implementation Fund will expire. As a result, EBSA-a small agency with just one investigator for every 13,900 plans it oversees-will be forced to lay off as much as 1 in 6 of its staff, jeopardizing bipartisan efforts to improve transparency for workers and employers.

To read the full text of the letter, click here.

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