Pittsburgh-based UPMC lost its bid to allow Blue Cross Blue Shield health plans outside of rival Highmark to contract directly with UPMC, according to the Pittsburgh Post-Gazette.
On April 16, a federal judge in Alabama ruled against UPMC's request to intervene in a seven-year-old lawsuit filed against BCBS plans by some of its members. The ruling by U.S. District Judge R. David Proctor can be appealed.
The ruling, if it stands, may further restrict patient volume at UPMC hospitals after a June 30 consent decree between Pittsburgh-based Highmark and UPMC expires. The ruling would make it more difficult for BCBS members outside of Pennsylvania to receive in-network care at UPMC.
Mr. Proctor said UPMC is too late in its request. In his ruling, he wrote: "For at least five years, UPMC has been exactly where it finds itself now — unable to contract with Blues other than Highmark after previously [albeit briefly] asserting that it has been unlawfully restricted from contracting with non-Highmark Blues."
UPMC officials said they are considering their options. UPMC lawyer Joe Whatley told the Pittsburgh Post-Gazette the ruling "was only a denial of the motion to intervene. It was not a ruling on the merits of any claim. We have a number of options we are considering."
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