Dive Brief:
- Pennsylvania's Governor Tom Wolf, who has taken up a vocal role in the dispute between rivals Highmark and UPMC, has announced that Highmark has agreed to pay all outstanding claims from UPMC providers and facilities since January 1, 2015. It will consider them as in-network so that patients will not be balanced billed for their care.
- Of the more than 900,000 claims that were filed on behalf of Highmark insurance customers using UPMC providers, nearly 97% were already paid as expected. The remaining 30,000 claims, or about 3%, had not yet been paid due to the dispute between the two healthcare organizations.
- The companies worked with the Pennsylvania Insurance Department to resolve the issue.
Dive Insight:
It's clear that the healthcare giants will not get a pass from Pennsylvania when it comes to patients getting caught in the middle of their business disputes.
It was only last week that Wolf announced a motion, filed by his administration with the assistance of the Attorney General, to protect the state's seniors from losing in-network access to their providers due to UPMC's plans to cancel its Highmark Medicare Advantage contract. The state is seeking to force both sides into arbitration.
Previously, Wolf announced in January that Highmark would continue to cover maternity care at UPMC's Magee-Womens Hospital this year for patients who became pregnant in 2014, even though it is no longer within the network.