UPMC to litigate over Highmark consent decree

Pittsburgh-based UPMC will fight a petition filed Feb. 7 by the Pennsylvania Attorney General's office seeking to modify a consent decree between UPMC and Pittsburgh-based Highmark that is set to expire June 30, according to GoErie.com.

At a press conference Feb. 7, Pennsylvania Attorney General Josh Shapiro said he requested "common sense" changes to the consent decree, which Highmark accepted. However, UPMC refused to make the changes.

Mr. Shapiro's petition is seeking changes that require UPMC to accept binding arbitration if an impasse is reached in contract negotiations with an insurer. The modified consent decree would protect patients from "excessive and unreasonable billing practices."

Mr. Shapiro claims UPMC has violated state law by restricting access to its network of hospitals and physicians. He said a legal review by his office revealed UPMC violated its charitable obligations by not negotiating with self-insured employers and denying access to certain patients who are covered by a competing health plan, according to the Pittsburgh Business Times.

Mr. Shapiro said his office is open to restarting negotiations with UPMC regarding the changes to the consent decree, but UPMC said it will argue its position in court.

"We're going to litigate," a UPMC spokesperson told GoErie.com. "We're going to go to court and we will see."

More articles on legal and regulatory issues:

10 arrested in $42M healthcare billing fraud scheme in Florida
New York hospital retaliated against 2 physicians for reporting dangerous care, lawsuits claim
15 latest healthcare industry lawsuits, settlements

Copyright © 2023 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars