- Pennsylvania Attorney General Josh Shapiro filed a petition Thursday asking a state court to intervene in the battle between nonprofit UPMC and rival system Highmark. Shapiro accused the integrated health system of failing to meet its obligations as a public charity by refusing to agree to new terms governing the relationship between the two companies.
- The existing state-brokered terms, which force the two to accept each others' members at their facilities, are set to expire in June. Highmark has agreed to the modified arrangement, but UPMC has not.
- Shapiro urged Pittsburgh-based UPMC to "change its mind" and "do the right thing" by agreeing to the terms. "Until then, I have no choice but to act to protect Pennsylvanians," Shapiro said at a press conference. "I can't sit idly by and watch our seniors and children and workers suffer because of corporate greed."
Tensions between UPMC and Highmark have been brewing for years as each competes for market share in Pennsylvania. The conflict came to a head when Highmark acquired West Penn Allegheny Health System, UPMC's top competitor in Pittsburgh, for $475 million in 2011.
A state-brokered consent decree was agreed upon in 2014 after UPMC stopped accepting Highmark members. Shapiro's office is arguing both parties have violated parts of the consent decrees and the attorney general is hoping to make the agreement more impenetrable.
Under the current consent agreement, UPMC has withheld access to care for patients whose employers have contracts with competing health plans and refused to negotiate payment terms with self-insured employers. The attorney general claims in the petition UPMC has violated the Solicitation of Funds for Charitable Purposes Act, the Nonprofit Corporation Law of 1988 and the Unfair Trade Practices and Consumer Protection Law.
"Given the effect this dispute between UPMC and Highmark is having on Pennsylvanians, and the imminent expiration of the existing consent decree, we are asking the court to take action," Shapiro said in a statement. "These changes are absolutely necessary to prevent UPMC from inflicting further harm on the public by forsaking its charitable obligations in pursuit of commercial success."
UPMC did not respond to Healthcare Dive's request for comment.