Highmark Medicare plan that excludes UPMC validated by court

A judge has ruled Pittsburgh-based health insurer Highmark’s Community Blue health plan, which considers most Pittsburgh-based UPMC hospitals and physicians out-of-network, does not violate the consent decrees Highmark and UPMC signed last summer, according to a TribLIVE report.

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Pennsylvania Gov. Tom Corbett (R) and the state’s Attorney General Kathleen Kane had requested Highmark be held in contempt of the consent decree it signed for excluding UPMC physicians and hospitals from its Medicare Advantage plan. To support their cause, they argued Highmark had agreed to provide full access to UPMC for all seniors, according to the report.

However, the judge disagreed, and ruled Highmark had not violated the consent decree because it also provides more costly plans that include UPMC facilities.

Highmark was pleased with the court’s decision and will continue to sell its Community Blue Medicare Advantage plans, according to the report.

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