Judge rules UPMC must offer in-network access to Highmark Medicare Advantage members

Commonwealth Court President Judge Dan Pellegrini granted the state's motion on Friday, requiring UPMC to continue to provide in-network access to Highmark Medicare Advantage members until 2019, which is the duration of the consent decree UPMC and Highmark entered into last summer, according to a Pittsburgh Post-Gazette report.

Earlier this year, UPMC warned those with Highmark Medicare Advantage plans would be pushed out of the system's network Jan. 1, 2016, unless Highmark increased the rates it pays UPMC for cancer care.

In April, Pennsylvania Gov. Tom Wolf and Pennsylvania Attorney General Kathleen Kane filed a joint motion alleging that UPMC's plan to end its Medicare Advantage arrangement with Highmark would violate the decree the UPMC and Highmark entered into in June 2014.

Judge Pellegrini granted the state's motion on Friday, and UPMC plans to appeal the decision to the Pennsylvania Supreme Court, according to the report.

Judge Pellegrini also set an arbitration schedule for Highmark and UPMC. The parties must submit a joint statement identifying any unresolved issues by July 1 and complete arbitration of those issues by Sept. 30.

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