UPMC said Pennsylvania's attorney general is working in Highmark's favor, not the public's, by filing a lawsuit against UPMC to prevent its breakup with Highmark, according to CBS affiliate KDKA.
In February, Pennsylvania Attorney General Josh Shapiro filed a petition against UPMC, arguing the Pittsburgh-based health system is not in compliance with the state's Public Charity law. The petition seeks to modify a consent decree between UPMC and Pittsburgh-based Highmark that is set to expire June 30. Starting July 1, roughly 175,000 Highmark Medicare Advantage plan members will lose in-network access to 11 UPMC hospitals and most UPMC physicians.
In late February, UPMC sued over Mr. Shapiro's attempt to compel the health system to work with Highmark, arguing the lawsuit is an overstep of authority. In a recent court filing cited by KDKA, UPMC said Mr. Shapiro "is trying to take the Consent Decree out of existence and implement — by coercion — an entirely new agreement that would take effect when the current one expires."
UPMC also accused Mr. Shapiro of working in Highmark's interest. According to the court filing cited by KDKA, UPMC said: "The requested modification would not only permit Highmark to tier providers and steer patients away from UPMC [and into its own health system] by requiring its members to make cost-prohibitive payments in order to access UPMC, but to also exclude UPMC entirely when it suits Highmark's needs. By arming Highmark with these exclusionary tools, the attorney general would nullify the very interest he is purportedly seeking to promote: affordable, in-network access to UPMC through compelled contracts."
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