UPMC-Highmark Comply with Request to Issue Statement

Impasse won't impact Medicaid, Medicare, Medicare Advantage, CHIP

At the request of the Senate Banking and Insurance Committee, UPMC and Highmark issued a joint statement affirming that their on-going contractual impasse will not affect people covered by Medicare, Medicare Advantage, Medicaid, and Children's Health Insurance Plan (CHIP), announced Committee Chairman Senator Don White (R-Indiana) and Senate Democratic Leader Jay Costa (D-Allegheny.

"There was a significant amount of concern and anxiety in the community that the contract impasse would mean that people covered by Medicaid, Medicare and CHIP would be adversely affected by the ending of the hospital services contracts in June," Senator White said. "Both UPMC and Highmark acknowledged that wasn't the case and that, in fact, those programs would be unaffected. We, as a Committee, asked them to put that information out in a public statement as a way to bring peace of mind to people and families who rely on those programs to pay for their health care needs."

"Senator White and I asked UPMC and Highmark to provide a statement in writing because we wanted to make it very clear to all program participants and parties involved that Medicare, Medicare Advantage, Medicaid and CHIP coverage would not change," said Senator Costa. "The termination of the hospital services contracts in June has caused so much stress for so many people. It gives me a level of reassurance, and I hope it helps to ease the minds of those who had expressed concern to us."

As part of a November 30 Banking and Insurance Committee public hearing in Pittsburgh, Senators White and Costa called on Dr. Ken Melani, President and CEO of Highmark, and Jeffrey Romoff, President and CEO of UPMC to issue the joint statement. UPMC and Highmark responded to that request by issuing the following statement:

"Highmark and UPMC want to jointly assure all Medicare, Medicare Advantage, Medicaid, and Children's Health Insurance Plan (CHIP) subscribers and patients that their in-network access to UPMC hospitals and physicians will not be affected by the changes in the contractual relationships between Highmark and UPMC. This means that Medicare, Medicare Advantage, Medicaid, and CHIP subscribers and patients will continue to have the same access in-network that they experience today."

The Senators said they were pleased with the statement and urged the companies to continue working to resolve their impasse. Highmark and UPMC are battling over the hospital services contracts which are set to expire on June 30, 2012. If the contract is not renewed, about 2,700 doctors in the UPMC system would be considered "out-of-network" for Highmark, which provides insurance coverage for about 3 million people in western Pennsylvania.

The Senate Banking and Insurance Committee unanimously approved legislation on December 13 to protect consumers if UPMC and Highmark do not settle their impasse.

Senate Bill 1358, jointly sponsored by Senator White and Senator Costa, amends state law to give the State Insurance Commissioner greater authority to extend the terms of the existing contract between Highmark and UPMC, thereby providing additional time to allow for adjustments to the health care marketplace in western Pennsylvania.

Under current law, the Pennsylvania Insurance Department can suspend for up to six months the termination of a hospital contract. Act 94 was enacted in 1975 to stabilize contractual relationships between Blues Plans and hospitals to ensure services remain available to subscribers while attempting to resolve impasses such as the one now occurring between Highmark and UPMC.

Contact:

Joe Pittman
(724) 357-0151