New deal between UPMC, Highmark extends in-network access
Under a new agreement, Highmark health insurance will maintain in-network access to University of Pittsburgh Medical Center hospitals in western Pennsylvania.
Gov. Tom Wolf thanked both health systems in an announcement on Thursday. Wolf, a Democrat, praised the rival companies for reaching the agreement following their 2014 contract. In-network access to UPMC facilities for Highmark patients was set to expire in 2019.
Children's Hospital of Pittsburgh of UPMC, UPMC Altoona, UPMC Bedford and multiple other hospitals and specialty facilities will remain open to Highmark patients. The locations include centers that specialize in transplant services, cancer treatment and psychiatric health.
"This is medical care that simply is not available anywhere else in the region, and denying affordable access to this vital care is just not acceptable," Wolf said in a release.
UPMC executive vice president David Farner praised the agreement. The pact helps preserve community-based care for patients across the state, Highmark president Deborah Rice-Johnson said.
The health system agreement doesn't address a dispute between Williamsport-based PMF Industries Inc. and UPMC, the Pittsburgh Post-Gazette reported. UPMC disagreed on PMF's use of reimbursement estimates that are based on Medicare rates. Evangelical Community Hospital has sided with UPMC in rejecting its reimbursement system.