Pa. insurance czar weighs in on UPMC-Highmark rift
PITTSBURGH — Pennsylvania insurance commissioner Michael Consedine said he may intervene if the Highmark health insurance company and the University of Pittsburgh Medical Center don’t agree on a new contract when their current deal expires next year.
Consedine believes he could invoke a seldom-used state law known as Act 94 to extend the current deal by six months after it expires next June 30, but acknowledges he has no power to force a deal.
“We’re still in a free market here,” Consedine told the Pittsburgh Tribune-Review for a story published Wednesday. “They have the ability to make their own business decisions, so we don’t have the ability to say, ‘You have to do a deal.’”
Still, Consedine told the Pittsburgh Post-Gazette that similar disputes have been resolved and resulted in new contracts.
“There’s a lot of passion involved on both sides and I’ve seen them go down to the wire many times,” said Consedine, an attorney who specializes in corporate insurance issues and regulations. “But, for the most part, you do end up with a new contract.”
Highmark and UPMC continue to disagree about when Highmark customers will be pushed out of UPMC’s network of doctors and hospitals. UPMC, the dominant health network in Western Pennsylvania with 19 hospitals and 2,900 doctors, has already said it won’t renew the contract because Highmark plans to buy UPMC’s primary competitor, the five-hospital West Penn Allegheny Health System.
On Wednesday, the rift became more rancorous when Highmark sued UPMC in federal court claiming UPMC’s new “Keep Your Doctor” ad campaign was designed to panic employers and subscribers into thinking they have to immediately sever their ties with Highmark to keep using UPMC’s services.
Although the contract expires June 30, a run-out clause would let Highmark customers keep using UPMC services for another year, through June 30, 2013. Highmark officials have said they still hoped to reach a reasonable deal with UPMC on behalf of its 3 million Western Pennsylvania customers before then, although UPMC officials have said that won’t happen.
