Last week the State Senate introduced and advanced a bill that will protect consumers if Highmark and UPMC allow their current contracts to expire in June without negotiating new agreements. When the contracts expire, patients will be forced to pay higher out-of-network rates for both hospital and physician services. Currently, there is a 12-month period after the contract expiration for consumers to submit claims and receive payment-in-full, but if the bill is enacted, the state insurance commissioner would have the authority to keep UPMC and Highmark working together for up to three years. Extending the agreement would provide stability for approximately three million Pennsylvanians who are covered by Highmark, including about 25 percent of the State System’s 12,000 employees.
Senate Bill 1358, sponsored by Sen. Don White (R-Indiana) and Sen. Jay Costa (D-Allegheny), was voted out of the Banking and Insurance Committee and now awaits action in the Appropriations Committee. It would amend state law to give the insurance commissioner the ability to extend the terms of the existing contracts and requires Highmark and UPMC to make good faith bargaining efforts.
At the request of the Senate Banking and Insurance Committee, UPMC and Highmark issued a joint statement yesterday indicating that patients covered by Medicare, Medicaid, and the Children’s Health Insurance Plan (CHIP) would not be affected by the expiration of the contracts and would continue to pay in-network rates for UPMC services.
The House of Representatives is also looking at legislation to address the dispute between Highmark and UPMC. House Bill 2052, sponsored by Rep. Randy Vulakovich (R-Allegheny), passed the House last week and would force the two sides into mediation that could lead to binding arbitration if unsuccessful.
APSCUF appreciates that the legislature is seeking to address the potential problem, which could affect as many as 30 percent of our members.
UPDATE: On Thursday, Dec. 22, Highmark and UPMC announced a temporary contract agreement extending through June 30, 2013. From the Pittsburgh Post-Gazette: