Speaker of the Pennsylvania House of Representatives Mike Turzai (R-Allegheny) said he is pleased with the announcement Monday of a long-term resolution between UPMC and Highmark that will give many Highmark members in-network access to UPMC doctors and hospitals.
Without the agreement, many Highmark members in Pittsburgh and Erie would have lost access to UPMC doctors on June 30.
“With the June 30 consent decree expiration fast approaching, we were preparing legislation to address concerns with access to care at Children’s Hospital, UPMC Hillman Cancer Center and UPMC Western Psychiatric Hospital,” Turzai said. “We are glad that UPMC and Highmark reached a solution that did not require another round of legislative intervention.”
Turzai has organized hearings in Pittsburgh and Erie to gather input on the impact of the dispute between the health care organizations. House Bill 2052 of 2011 was authored in response to the findings of the hearings. It would have provided for binding arbitration between a Blue Cross insurer, like Highmark, and a health care provider, like UPMC, where the public interest required it. After the House advanced the bill, UPMC and Highmark signed a negotiated settlement that extended the consent decree through June 30, 2019.
“After the mediated agreement of 2012 and the consent decree signing in 2014, our Republican House members continued to meet with patients, health care providers, health insurers and government leaders to seek a sustainable outcome of the separation process as UPMC and Highmark approached the June 30, 2019, consent decree expiration date,” Turzai said.
Turzai said that after recent news that UPMC agreed to provide Highmark cardholders with in-network access to Hillman Cancer Center, he and other House Republican members reached out to leadership of the organizations to encourage them to reach a more comprehensive agreement before the decree expired.
“Our approach, as always, was not rooted in making splashy headlines but was focused on substantive solutions that would make sure patients had access to quality health care, and that competition would still encourage competitive, reasonable insurance rates,” Turzai said.