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MultiPlan, the secret back-end to most of the insurer industry, is going public

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In a recent announcement, MultiPlan, an entity offering a shadow provider network to insurers, declared that it was going public through a SPAC. Upon closer inspection, MultiPlan represents some of the worst aspects of American health care.

The world of health insurance is deliberately murky. There are monthly premiums, basically a subscription to access the insurance; deductibles, which are minimum amounts a patient pays before the insurance kicks in, usually in an emergency or surgery setting; and co-pays, which are additional fees the patient pays for the privilege of seeing a doctor, usually $20-70.

All of the patient-side fees are confusing, but the provider-side is even more so. Insurers handle negotiations with doctors and hospitals (and, importantly, negotiating with a doctor does not necessarily mean the insurer has negotiated with the hospital and vice versa) to reach a set price for a specific service. These prices are negotiated down from the hospital or physician’s chargemaster (a list of prices). The chargemaster bears no relation to actual charges but is instead the provider’s best attempt to set a high bar at the outset of a negotiation process. When an uninsured patient is billed an extraordinary amount, it’s usually because they didn’t have the negotiation layer of an insurer built in.

The purported value add of insurers, then, is that they lessen costs for patients by handling catastrophic expenses and negotiating down high provider fees.

For a few reasons, this isn’t wholly true. For one, health systems are increasingly merging with insurers, meaning any “negotiation” on behalf of the patient is happening within two divisions of the same company.

But also, many insurers are doing much less negotiation than they make it seem.

The corporation also uses a Palantir-like combination of algorithm and human to root out “fraud and abuse” in payments. 

Three weeks ago, a new merger announcement threw the health care world into a bit of a tizzy. MultiPlan, a complementary PPO network, announced it was going public via a SPAC. The announcement forced quite a few people to start looking up what MultiPlan actually does, including me.

MultiPlan, it turns out, is a corporation that handles a lot of insurers’ work for them. It handles negotiation with providers nationwide and consequently has the largest preferred provider network in the country. This means that insurers can contract with MultiPlan and simply get access to MultiPlan’s network, rather than doing thousands of negotiations. This service is so valuable that all 10 of the top 10 insurers use it, and the corporation seems to have carved out a little monopoly at the top.

MultiPlan didn’t start with so much power. It was founded in 1980 to solve an growing problem: when people traveled, their narrow network insurance plans didn’t follow them. If a person from Delaware had an accident in Colorado, they likely fell out of network and did not receive insurance coverage. To fill this gap, MultiPlan formed a network of “shadow contracts,” negotiated rates with providers that fell outside most networks, and sold this network to other insurance plans.

Over time, as the main insurers became bigger and more national, these shadow contracts became less important. But MultiPlan remained at the top of the insurer network, mostly because the Affordable Care Act of 2010 triggered an avalanche of startup insurers (Oscar, Clover, etc.) while also mandating that insurers cover out-of-network emergency care (although it did not ban surprise billing). MultiPlan offered these smaller insurers an easy way to access a large network of providers.

In 2006, private equity firms began eyeing MultiPlan as a valuable service with few competitors, a market position that only grew after the aforementioned 2010 ACA devlopments. Over the ten years from 2006 to 2016, MultiPlan changed hands between PE firms no fewer than four times. Meanwhile, MultiPlan was also making large acquisitions of competitors and firms in adjacent spaces:

  • 2006: MultiPlan acquired by Carlyle Group for $1 billion
  • 2006: MultiPlan acquires PHCS, the largest primary care network in the US
  • 2010: MultiPlan acquired by BC Partners and Silver Lake for $3.1 billion
  • 2010: MultiPlan acquires Viant, another competitor
  • 2011: MultiPlan acquires NCN, a reimbursement management platform
  • 2014: MultiPlan acquired by Starr Investment Holdings and Partners Group for $4.4 billion
  • 2014: MultiPlan acquires Medical Alert & Review, which identifies wasteful billing
  • 2016: MultiPlan acquired by Hellman & Friedman for $7.5 billion

Not only did MultiPlan’s value increase by a factor of more than 7 times over 10 years—its owners “cleaned up,” in the words of a Wall Street Journal blog post— it also acquired many of its potential competitors. To my knowledge, MultiPlan no longer has competitors. It’s just MultiPlan and the insurers that use it.

Following some of these acquisitions, MultiPlan expanded its service offerings beyond provider negotiation. The corporation also uses a Palantir-like combination of algorithm and human to root out “fraud and abuse” in payments. And for insurers who worry about what their members think of them, MultiPlan offers a set of analytics services that “balance[s] out-of-network savings and member service.”

From what I can tell, this means MultiPlan has a side business in blocking certain treatments and medications to save the insurer money, or at least making things very hard on doctors who try to prescribe expensive care.

This makes sense from MultiPlan’s perspective, as MultiPlan’s revenue (as far as I can tell—they’re not yet public) comes from a combination of the contract fees that insurers pay to access MultiPlan’s network, in addition to a percentage of the “savings” MultiPlan gets for insurers by routinely lowballing doctors.

Theoretically, MultiPlan’s harsh negotiation tactics should be good for rising American health care costs; insurers are supposed to lower costs by negotiating lower prices on behalf of the patient.

But instead, MultiPlan acts like a mafia enforcer for insurers, forcing doctors to accept low payments while insurance premiums for patients…somehow continue to rise.

MultiPlan’s key strategy for forcing doctors to accept low prices is by erecting a bureaucratic layer so thick and complicated that few can navigate it. On one MultiPlan fax to a doctor that I saw, MultiPlan gave the physician 8 days to respond to a low-ball negotiation. “Please note that if you do not wish to sign the attached proposal,” the fax said, “this claim is subject to a payment as low as 110% of Medicare rate as based on the guidelines and limits on the plan for this patient.”

In other words, if the physician disagrees with MultiPlan’s reimbursement offer, MultiPlan reserves the right to cut the price even lower.

MultiPlan preys on physicians using these subtly forceful faxes, expecting physicians’ medical billing staff to not have time to fight through layers of bureaucratic tape. And according to a friend who works in medical billing, even if a staff member takes it upon themselves to complain about a low rate to MultiPlan, MultiPlan refuses to negotiate on the grounds that it is not the insurer.

Now MultiPlan is going public via a SPAC. There’s a lot of money to be made in leveraging the fragmentation of the health care system and bending physicians to your will, and Churchill Capital looks ready to sweep it up.

Olivia Webb. (2020, August 5). MultiPlan, the secret back-end to most of the insurer industry, is going public. Acute Condition. https://www.acutecondition.com/p/multiplan-the-secret-back-end-to?fbclid=IwAR342wrhyNVpIY_mKp7HY8-6TlwXDFudVrJALD49ZZVvRbBJxdJnTAVyIp8

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Owners of Lee’s Sandwiches Found Guilty

“Their Greed Could have Endangered Many”

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Lee's Sandwiches in Garden Grove, CA

On March 18, 2021, a guilty verdict was found in a judgement by the United States District Court against LQNN, INC and the owners; CEO Le Van Chieu and COO Tom Quach.

Le Van Chieu’s wife, Yen Ngoc Quach, is also the sister of Tom Quach, and they co-own Lee’s Sandwiches. These criminals were convicted and fined $250,000 for printing fake USDA labels on their Lee’s Sandwiches products. If it wasn’t for the timely discover by the USDA, their greed could have endangered many.  As confessed by Tom Quach while in court, the designer that helped create these fake labels was Giang Vu. Giang Vu was well connected and had close relationships with Vietnamese newspapers in the U.S., but was only a pawn under Le Van Chieu. Attached are documents of the actual court ruling in both English and Vietnamese because the judgement is enforceable in both countries.

If you are a victim of this incident and under 18 years of age or under political imprisonment being abused for underpaid or unpaid labor while working on a coffee farm or sugar cane farm in Vietnam that produced for Lee’s Sandwiches, you can receive safe passage to the U.S.

Vào ngày 18 tháng 3 năm 2021, một bản án có tội đã được Tòa án Quận Hoa Kỳ tuyên đối với LQNN, INC và các chủ sở hữu; CEO Lê Văn Chiêu and COO Tom Quách.

Vợ của Lê Văn Chiêu, Yến Ngọc Quách, cũng là chị gái của Tom Quách, và họ đồng sở hữu Lee’s Sandwiches. Những tên tội phạm hình sự này đã bị kết án và phạt 250.000 USD vì in nhãn USDA giả trên sản phẩm Lee’s Sandwiches của họ. Nếu không được USDA phát hiện kịp thời, hành động của họ có thể khiến nhiều người thiệt mạng. Theo lời thú nhận của Tom Quách khi hầu tòa, người thiết kế giúp tạo ra những chiếc nhãn giả này chính là Giang Vũ. Giang Vũ có mối quan hệ tốt và có quan hệ mật thiết với các tờ báo Việt Nam tại Mỹ, nhưng chỉ là con cờ dưới thời Lê Văn Chiêu. Đính kèm là các tài liệu về phán quyết thực tế của tòa án bằng cả tiếng Anh và tiếng Việt vì bản án có hiệu lực thi hành ở cả hai quốc gia.

Nếu bạn là nạn nhân của vụ việc này và dưới 18 tuổi hoặc đang bị phạt tù chính trị bị lạm dụng lao động, hoặc làm không công trong khi làm việc tại một trang trại cà phê hoặc trang trại mía đường ở Việt Nam sản xuất cho Lee’s Sandwiches, bạn có thể được đi Mỹ an toàn.

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Images Luxury Nail Lounge Salons File $5 Million in Claims for Nail Salon Closure Order That Singles Out the Vietnamese Community

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Images Luxury Nail Lounge manicurists servicing clients at Alton Parkway Salon

NEWPORT BEACH, Calif.Sept. 23, 2020 /PRNewswire/ — Images Luxury Nail Lounge salons, with locations in IrvineNewport Beach and Long Beach, today filed over $5,000,000 in claims against the cities of IrvineNewport BeachLong Beach, the counties of OrangeLos Angeles, and the State of California (collectively “the Government”) for the Government’s continued forced closure of their nail salons.

“We can’t open outside.  Most of the malls we are in won’t allow it, and our chairs and equipment are bolted into the floor.”  

The Images Luxury Nail Lounge salons are alleging that the Government violates their constitutional rights under the federal and California Constitutions due to enforcement of Governor Newsom’s March 19, 2020, executive order. While other similar businesses have subsequently been permitted to open, nail salons remain shuttered.

Tony Nguyen, General Manager of the Image Luxury Nail Lounge salons, notes that “the Vietnamese community has been singled out in this unfair and arbitrary order.”  Vietnamese own 80% of the 11,000 nail salons in California. Mr. Nguyen points out that “since the State, County and Cities have now allowed hair salons to fully reopen, it is evident that the government is enforcing these laws in a racist manner.  With hair, for example, the stylist is right in your face, while with a nail salon, you can be an arm’s length away. Yet hair salons have already been allowed to fully reopen, but Vietnamese owned nail salons are effectively not.” While nail salons are now allowed to open outdoors, Mr. Nguyen states, “we can’t open outside.  Most of the malls we are in won’t allow it, and our chairs and equipment are bolted into the floor.”  

The claims filed today note that there has been no income for six months although nail salons continue to have fix costs such as lease obligations, licensing fees and taxes, etc.  Moreover, nail salons have made the necessary accommodations to ensure the safety of their clients, including, but not limited to, mandated masks and social distancing measures, eliminating indoor waiting areas, incorporating touch-free check-in and check-out, only using every other chair, etc. These accommodations make nail salons safe or safer than other businesses.  Despite these accommodations, nail salons continue to be closed while other less safe businesses have been allowed to open. Mr. Nguyen notes that “Images Luxury Nail Lounge salons are simply seeking to be paid back the money the government effectively took from them through the enforcement of these arbitrary laws that are being enforced in a racist manner. “

For More Information contact: Tony Nguyen, (949) 205-9415, tony@imagesnaillounge.com

About Images Luxury Nail Lounge:

Images Luxury Nail Lounge first opened its doors in 2014. With their state-of-the-art interior and professional-grade cosmetic procedures, each Images location offers a unique experience. Now with 5 prime locations in Southern California, Images Luxury Nail Lounge is ranked the 24th “Top Company” in Los Angeles and the 253rd “FASTEST GROWING BUSINESSES IN THE COUNTRY” by Inc. Magazine’s Top 500 for 2017.

Images Luxury Nail Lounge has established a prestigious reputable name. Images Luxury Nail Lounge is now offering both lucrative partnerships and business opportunities nationwide. So, if you are interested in joining Images’ growing success in the cosmetic and spa service industry, this is your opportunity to establish your own luxury salon with the benefit of a great support system and a well-established and recognizable brand. Investment opportunities are also.

Images Luxury Nail Lounge. (2020, September 23). Images Luxury Nail Lounge Salons File $5 Million in Claims for Nail Salon Closure Order That Singles Out the Vietnamese Community. PRnewsire. https://www.prnewswire.com/news-releases/images-luxury-nail-lounge-salons-file-5-million-in-claims-for-nail-salon-closure-order-that-singles-out-the-vietnamese-community-301136369.html

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Thợ nail được tiếp tục làm việc theo diện độc lập qua đạo luật AB 1561

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Thợ nail có thể được tiếp tục làm việc độc lập. (Hình minh họa: Angela Weiss/AFP via Getty Images)

SACRAMENTO, California (NV) – Dân Biểu Janet Nguyễn công bố AB 1561 được Quốc Hội California thông qua, cho phép thợ nail làm việc độc lập đến Tháng Giêng, 2025.

Theo thông cáo của Dân Biểu Janet Nguyễn, vào năm 2019, đạo luật AB 5 gây khó khăn cho cư dân làm việc theo diện độc lập trừ một số trường hợp ngoại lệ.

“Những người làm nail và tiệm nail đã nhiều lần bị tiểu bang kỳ thị và không quan tâm đến. AB 1561 sẽ cho ngành này thêm thời gian để làm việc với tư cách là người làm việc độc lập theo lựa chọn của họ. Đồng thời, tôi có thêm thời gian tiếp tục làm việc với các đồng viện ở Sacramento để bảo đảm ngành nail được gia hạn vĩnh viễn.”

Trừ thợ nail, mọi nghề khách trong ngành thẩm mỹ đều được miễn trừ. Thợ nail chỉ được miễn trừ cho đến ngày 1 Tháng Giêng, 2022.

Dân Biểu Janet Nguyễn phát biểu: “Những người làm nail và tiệm nail đã nhiều lần bị tiểu bang kỳ thị và không quan tâm đến. AB 1561 sẽ cho ngành này thêm thời gian để làm việc với tư cách là người làm việc độc lập theo lựa chọn của họ. Đồng thời, tôi có thêm thời gian tiếp tục làm việc với các đồng viện ở Sacramento để bảo đảm ngành nail được gia hạn vĩnh viễn.”

Dân Biểu Janet Nguyễn cho biết bà rất chú tâm trong việc sửa đổi sự bất công trong ngành nail. Bà từng đệ trình AB 231 vào đầu năm nay để những người thợ nail được gia hạn vĩnh viễn và nêu lên sự bất công để bắt đầu sự thảo luận về sự sửa đổi này.

Vì đây là một vấn đề quan trọng và không còn nhiều thời gian, dân biểu đã cùng các đồng viện thảo luận thành công để đưa ngành nail vào dự luật của Ủy Ban Lao Động và Việc Làm, AB 1561.

Dân biểu cho hay 80% thợ nail và chủ tiệm nail ở California là người Mỹ gốc Việt. Đây là ngành tạo ra việc làm lớn nhất cho cộng đồng. Orange County có số người tị nạn Mỹ gốc Việt đang sinh sống lớn nhất ngoài Việt Nam.

“Sự ủng hộ mạnh mẽ của tôi đối với AB 1561 thể hiện sự cam kết của tôi là một dân biểu đại diện cho quý đồng hương trong Địa Hạt 72. Tôi sẽ luôn đại diện và tranh đấu để bảo đảm đời sống kinh tế cho quý đồng hương và gia đình,” Dân Biểu Janet Nguyễn cho hay.

Bà từng là tác giả của một số đạo luật ủng hộ ngành nail như SB 1044 và SB 896. Tuy SB 896 không được ký thành luật, nhưng SB 1044 được thông qua và giúp các tiệm nail, cũng như thợ không phải đóng tiền phạt nhiều gấp đôi. Đạo luật SB 1044 còn tạo ra một hệ thống đóng tiền phạt trả góp cho chủ và thợ nail. 

(TL) [qd] (October 27, 2021). Thợ nail được tiếp tục làm việc theo diện độc lập qua đạo luật AB 1561. Nguoi-Viet.com https://www.nguoi-viet.com/little-saigon/tho-nail-duoc-tiep-tuc-lam-viec-theo-dien-doc-lap-qua-dao-luat-ab-1561/

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