Feb. 8, 2019
Dive Brief:
- 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."
Dive Insight:
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.
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