House Leaders Applaud Passage of Legislation to End UPMC-Highmark Dispute, Urge Senate Action
12/22/2011
PITTSBURGH – A bipartisan group of state House members, including House Majority Leader Mike Turzai (R-Allegheny) and Democratic Leader Frank Dermody (D-Allegheny), today held a press conference urging Senate action on legislation to end the University of Pittsburgh Medical Center (UPMC) and Highmark dispute. House Bill 2052, sponsored by Rep. Randy Vulakovich (R-Allegheny), would add tools to resolve disputes between hospitals and insurers and protect consumers.

“The UPMC-Highmark dispute has a huge impact on our region, affecting health care services for millions of consumers,” Turzai said. “The legislation, which overwhelmingly passed the House, will protect consumers from disruptions in care and vital services as a result of a dispute between health care providers.”

“Access to health care is one of the most serious concerns people have in their everyday lives,” Dermody said. “It should never be put at risk because of a business dispute. The current battle is causing problems for employers who have to make long-range decisions about insurance coverage without knowing how to plan, as well as unwanted stress for millions of consumers. It needs to get fixed.”

House Bill 2052 empowers the Pennsylvania Insurance Department with an effective means of assisting in the resolution of disputes between health care providers and insurers by: 

        • Requiring the department to hold investigative public hearings should a dispute arise. 
        • Calling for the parties in a dispute to participate in mediation if the department finds 
          that the contract termination or expiration would substantially affect public health in 
          the area serviced by the insurer. 
        • Submitting the parties to binding arbitration if mediation fails and the secretary of 
          health finds that termination or expiration of the contract would substantially disrupt 
          the delivery of health care services in the area serviced by the insurer and that 
          continuation of the contract is in the public interest.

“The Senate should work diligently to pass this legislation as soon as possible,” Vulakovich said. “As legislators, we cannot just watch from the sidelines as our constituents lose access to
some of the best health care anywhere. The people of Pennsylvania should not further be subject to prolonged contract disputes that threaten excellent patient care and services.”

UPMC is western Pennsylvania’s largest hospital and physician network. Highmark controls 65 percent of the region’s health insurance market. Under the current contract, Highmark members are able to see UPMC doctors and use UPMC facilities at “in-network” rates. The contract between UPMC and Highmark is set to expire on June 30, 2012. As a result of the contractual dispute between the two entities, 2,700 UPMC doctors and affiliated hospitals will become out-of-network providers to approximately 3 million Highmark subscribers. Out-of-network fees are generally much higher than in-network, resulting in higher out-of-pocket expenses for consumers.

The legislation passed the House on Dec. 15 by a bipartisan vote of 186-6.

Pennsylvania House of Representatives
Rep. Mike Turzai
Media Contact: Rep. Frank Dermody
Media Contact:
Tricia Graham, 412-913-6812
Bill Patton, 717-433-7604
tgraham@pahousegop.com
bpatton@pahouse.net

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