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Court ruling protects seniors

State prevails in health care feud

HARRISBURG — Gov. Tom Wolf and Attorney General Kathleen Kane hailed a court decision Friday that they had sought in a bid to protect Medicare Advantage enrollees caught in the middle of a feud between two Western Pennsylvania health care giants.

The ruling by Commonwealth Court Judge Dan Pellegrini orders the University of Pittsburgh Medical Center’s health system to maintain in-network rates until 2019 for people insured by Medicare Advantage plans sold through insurer Highmark Inc.

In addition, Pellegrini ordered the two companies into arbitration to iron out disagreements over the terms of a state-mediated consent decree the parties signed last year. The companies may not make changes to any plan, contract or business relationship between the two “no matter how small” without first getting approval from the court, Pellegrini wrote.

The move in April by UPMC to cancel its Medicare Advantage contract with rival Highmark had meant about 180,000 seniors in Western Pennsylvania could lose in-network access to UPMC hospitals and doctors next year. The Wolf administration and the state attorney general’s office went to court seeking to block the move.

Kane’s office said the decision vindicated its position and gives clarity to seniors. Wolf chastised both Highmark and UPMC, and accused the companies of using the vulnerable health care customers as “pawns” in their long-running dispute.

“The feud between these two companies must end — the people of Western Pennsylvania have had enough,” Wolf said in a statement.

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