UPMC bars 700 physicians from Highmark Medicare Advantage plans

UPMC will not allow 689 of its physicians to participate in Highmark Medicare Advantage plans after the Pittsburgh-based insurer terminated their contracts last week, according to the Pittsburgh Business Times.

After previous negotiations failed, Highmark ended the UPMC physicians' contracts in a move to clarify for subscribers which physicians would be in network Jan. 1. The insurer later sent the physicians new contracts to continue to treat Medicare managed care patients within their network.

"We're not going to reward Highmark's illegal and unethical behavior by entering into the new contracts they want," UPMC spokesman Paul Wood said. "Highmark has no network."

In July, the two healthcare companies signed an agreement to grant Highmark seniors full access to UPMC physicians and hospitals, which UPMC feels is unlawful, according to the report.

Highmark insurance must cover an adequate network of providers, which the state Department of Health has been monitoring throughout the dispute, according to the report. The insurance company, which covers the most Medicare Advantage beneficiaries in the region, has taken a public position on the issue, claiming they have enough physicians to care for the senior population, according to a statement in the report from Michael Cassidy, JD, a Tucker Arensberg attorney who represents Pittsburg physcians and medical practices.

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