UPMC-Highmark dispute on feds' radar, Azar says

HHS Secretary Alex Azar and another CMS official commented on the ongoing feud between Pittsburgh-based UPMC and Highmark Health, according to the Pittsburgh Post-Gazette.

Here are three things to know:

1. A state-brokered agreement between Highmark and UPMC expires June 30, 2019. Once it expires, Highmark Medicare Advantage members will be unable to obtain in-network rates at UPMC facilities — including 10 hospitals — that are slated to go out of network with Highmark in 2019. In July 2019, Highmark MA members will also have to pay any estimated upfront charges for nonemergent treatment in full before accessing care from most UPMC providers, UPMC said in an Oct. 1 internal memo obtained by Trib Live.

2. During a press briefing Oct. 12, Mr. Azar said federal officials "know about [the dispute]" and are "aware of it," adding that HHS is not making any judgments, but is concerned with "protecting the beneficiaries," the report states.

3. Mr. Azar's press briefing Oct. 12 was held to discuss a new federal law allowing pharmacists to tell customers if a prescription would be cheaper if they paid with cash instead of using their insurance.

To access the full report, click here.

Editor's note: Becker's Hospital Review reached out to UPMC for comment and will update the report as more information becomes available.

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