UPMC sues Pennsylvania AG, says state can't interfere in Highmark dispute

UPMC claimed Pennsylvania's attempt to compel the health system to work with rival Highmark after a state-brokered agreement expires is an overstep of authority, according to Trib Live.

Four things to know:

1. In Feb. 21 court filings, Pittsburgh-based UPMC asked the Commonwealth Court to toss Pennsylvania Attorney General Josh Shapiro's petition to rewrite a 2014 consent decree with Pittsburgh-based Highmark that is set to expire June 30. Starting July 1, roughly 175,000 Highmark Medicare Advantage plan members will lose in-network access to 11 UPMC hospitals and most UPMC physicians.

2. In addition to the court documents, UPMC filed a class-action lawsuit in federal court. The lawsuit seeks relief from the "unlawful state interference," accusing Mr. Shapiro of pursuing action that is "anti-competitive" and violates federal regulations, according to Trib Live.

3. The litigation comes after Mr. Shapiro filed a petition Feb. 7 against UPMC, seeking changes that require UPMC to accept binding arbitration if an impasse is reached in contract negotiations with an insurer. The modified consent decree would protect patients from "excessive and unreasonable billing practices." UPMC previously said it planned to litigate the petition.

4. In a statement to the publication, Mr. Shapiro's office said, "With their filings [Feb. 21], UPMC has shown they intend to spend countless hours and untold resources on a legal battle instead of focusing on their stated mission as a nonprofit charity — promoting the public interest and providing patient access to affordable healthcare." The office added it is "very confident" in its legal petition.

For the full Trib Live article, click here.

Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Podcast

Featured Webinars

Featured Whitepapers

Top 40 articles from the past 6 months