The Fifth Avenue Place headquarters of Highmark seen with the U.S. Steel Tower offices of UPMC in Downtown Pittsburgh.
By Karen Langley / Post-Gazette Harrisburg Bureau
HARRISBURG — Gov. Tom Corbett is scheduled to meet today with members of the boards of UPMC and Highmark as state officials urge the Pittsburgh health care giants to resolve issues of consumer access ahead of a threatened contract expiration at the end of this year.
The meeting comes eight days after Mr. Corbett announced he had asked Insurance Commissioner Michael Consedine and Michael Wolf, Department of Health secretary, to facilitate discussions with Highmark and UPMC senior management. In announcing the “Patients First” leadership team, the governor said the companies must form a plan so that Highmark policyholders can continue to see UPMC doctors at affordable prices.
“That’s what we’ll be talking about: the patients first,” Mr. Corbett said in a brief interview Monday. “We’ve got to take care of the patients first.”
The state attorney general’s office joined the Corbett administration in talks late last week with UPMC and Highmark. On Monday, the Post-Gazette reported that the attorney general’s office has prepared a legal complaint against UPMC that it could file if the discussions do not resolve key issues, according to several people with knowledge of the matter.
The complaint addresses issues relating to consumer protection and to UPMC’s legal obligations as a nonprofit charity.
The chairmen of the boards of UPMC and Highmark are scheduled to attend today’s meeting at the Capitol with the governor, according to a person with direct knowledge of the plans. The source said the purpose of the meeting is to encourage the board members to advise the UPMC and Highmark management to cooperate with state regulators.
A spokeswoman for Mr. Corbett said the meetings last week focused on patient access to emergency rooms, continuity of care for patients in the middle of treatment, patient access to hospitals close to their homes and efforts to minimize disruption and cost to patients during a transition at the expiration of a contract.
Representatives of UPMC and Highmark declined to comment on the meetings.
UPMC maintains it will not negotiate a new reimbursement contract, which would offer health care services at in-network rates to Highmark’s commercial insurance patients, now that Highmark has acquired West Penn Allegheny Health System and launched its own health network.
Mr. Corbett, who is running for re-election this year, two years ago brokered a contract extension that is set to expire at the end of 2014, and Highmark faces a July 31 deadline to file a post-contract transition plan.
State Sen. Jay Costa, D-Forest Hills, and state Rep. Dan Frankel, D-Squirrel Hill, wrote to Mr. Corbett last week asking to meet with the “Patients First” team. Mr. Costa, along with Sen. Randy Vulakovich, R-Shaler, and Mr. Frankel, along with Rep. Jim Christiana, R-Beaver, have proposed legislation to require integrated delivery networks, such as UPMC, to contract with any willing insurer.
Whatever the final resolution, an association of local employers wants it to happen soon.
Although Highmark must submit a post-contract transition plan to state regulators by next month — five months before the contract is set to expire — that is too late, says Jessica Brooks, executive director of the Pittsburgh Business Group on Health.
“Employer decisions are being made now, so it’s too important to wait for resolution or comprehensive work plans for transition of care.”
The group on Monday announced its own effort, “The Priority Initiative,” calling for face-to-face meetings between Highmark and UPMC and input with state officials, including Mr. Corbett, to clarify what the situation will be if there is no contract Jan. 1.
“There needs to be a greater sense of urgency on the part of Highmark and UPMC to resolve outstanding issues and publish complete transitional plans so employers can make good, sensible decisions about their company’s health care plans,” said Ms. Brooks.
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