UPMC notified the Pennsylvania Insurance Department June 5 of the reversal, which comes months after the prepayment policy was announced in October. In addition, UPMC said it will now accept direct payment for out-of-network emergency services from Highmark at the same rate that UPMC Health Plan pays Pittsburgh-based Allegheny Health Network hospitals, which are part of Highmark.
On June 4, the Pittsburgh Post-Gazette reported federal officials were taking a closer look at the proposed prepayment policy, which would have required Highmark Medicare Advantage members to pay the estimated cost of care in full before receiving care from UPMC providers.
The removal of the policy won’t sway a larger push by Pennsylvania’s attorney general to force UPMC to agree to extending the consent decrees, according to the report.
More articles on payers:
Supreme Court sides with hospitals in multibillion-dollar payment dispute
Hospitals can’t challenge Medicare payment methodology, court rules
Tennessee hospital to lose Medicare contract
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
