Docs: Highmark, UPMC should smooth transition

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While continuing to maintain that an agreement between insurer Highmark Inc. and provider UPMC is the preferred outcome, the Allegheny County Medical Society is now saying that "we recognize that may not happen; and therefore, UPMC and Highmark should formalize an orderly transition plan to minimize disruption of care and costs."

UPMC officials have been pushing for such a transition plan once they declared they would not renew UPMC's contract with Highmark; Highmark officials say they want to negotiate a contract, but will not discuss a separation.

The current contract expires June 30, with a one-year run out period for hospital services; the two sides disagree about whether the run out period includes physician services.

While the medical society statement appears to agree with UPMC, a letter accompanying the statement sent to local physicians by the medical society's president, plastic surgeon Leo McCafferty, stresses that the group "is not picking sides" in the ongoing contract dispute.

The medical society statement asks for clarification of what additional out-of-network costs Highmark subscribers would face if the contract ends and any effect on government programs such as Medicare and Medicaid. It also argues that insurance contracts should be made public and subject to state review.

The statement sets out several other points, including encouraging state officials to "make a decision on whether or not to invoke Pennsylvania law and extend the existing contract through December of 2012." An extension would help employers because most benefit plans are renewed on a calendar year basis, the statement said.

UPMC officials have said they do not believe the law applies in this case.


Steve Twedt: stwedt@post-gazette.com or 412-263-1963.


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