Senate Banking & Insurance Committee Chair Commends UPMC and Highmark on Reaching Consensus

Harrisburg – Pennsylvania Senate Banking and Insurance Committee Chair Senator Mario Scavello (R-40) today commended UPMC and Highmark for reaching a consensus on health care delivery in western Pennsylvania.

On Wednesday, UPMC informed the Pennsylvania Insurance Department and Highmark that it will not seek pre-payment from out-of-network Highmark Medicare Advantage members after the Consent Decrees end on June 30. Additionally, for out-of-network emergency care, UPMC will accept direct payment from Highmark at the same rate that UPMC Health Plan now pays Highmark’s Allegheny Health Network hospitals.

The announcement was prompted by recent statements from Highmark indicating that it will pay UPMC directly and in full for many of these services.

On Thursday, UPMC also agreed to make all UPMC Hillman Cancer Center locations available to all insurers, including all Highmark commercial and Medicare Advantage members, at currently agreed upon in-network rates after the expiration of the Consent Decrees on June 30, 2019.

“As Chair of the Senate standing committee with oversight of the insurance industry and insurance landscape in Pennsylvania, I am pleased that these providers are working to resolve some of the issues in the western Pennsylvania health insurance market,” said Scavello. “I hope there continues to be open communication between the providers and this mutual understanding continues in the long term.”

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CONTACT: Christine Zubeck (717) 787-6123