UPMC backpedals on controversial prepayment policy


UPMC no longer plans to require patients with Medicare Advantage coverage through Highmark to pay for services in advance once consent decrees between the Pittsburgh-based rivals expire July 1, according to the Pittsburgh Post-Gazette.  

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.

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