Health Care - May 4, 2012

Highmark and UPMC Reach Deal

Highmark and the University of Pittsburgh Medical Center have reached a deal that will extend until Dec 31, 2014.  For now Highmark customers who utilize provides and services through UPMC will not be forced to find other providers; and the two “have agreed to negotiate rates and terms for continued Highmark member access to certain UPMC services on an in-network basis starting in 2015.”  Also part of the deal, current reimbursement rates Highmark pays to UPMC will increase and those costs will likely be passed onto Highmark customers.

Governor Corbett tapped David F. Simon, Executive Vice President and Chief Legal Officer of Jefferson Health System in Southeastern Pennsylvania, to serve as a mediator during recent negotiations.  Corbett stated that Simon’s expertise in insurance and health system finance was vital” and that “having a neutral third party was essential” to reaching a deal.

The deal will be finalized by June 30, 2012 and as part of the agreement Highmark will also drop its federal lawsuit against UPMC for false advertisement.  UPMC had run an ad campaign titled “Keep Your Doctor,” which, the Pittsburgh Post-Gazette reports, Highmark claimed was an attempt to “panic Highmark subscribers by making it appear they were about to lose in-network access to UPMC physicians and hospitals."


PA House Approves Bill to Auction Casino License reports that Pennsylvania State House of Representatives approved a measure this week to hold a statewide auction to award the license that was previously held for the failed Foxwoods Casino project in South Philadelphia.  The House voted 140-48 on the bill to auction the license with bids starting at $66.5 million.    The license can be used anywhere in the state, though, the Gaming Control Board would have the final say on where.  The Gaming Control Board also has the final say on to whom the license would go.  The bill will head to the Senate next where it will surely be hotly debated before any vote.