Pa. House legislators tackle UPMC-Highmark dispute

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HARRISBURG -- Two Western Pennsylvania legislators from opposite sides of the aisle are putting forth two bills they say would protect health care consumers and preserve patient choice in the ongoing UPMC-Highmark dispute.

The measures would require hospitals and physician-owned practices that "are part of an integrated delivery network" -- such as UPMC -- "to contract with any willing insurer."

Co-sponsors Rep. Dan Frankel, D-Squirrel Hill, and Rep. Jim Christiana, R-Beaver, discussed the bills at a press conference in Harrisburg on Wednesday morning, accompanied by two nurses.

"I am the first to criticize government for putting its nose where it doesn't belong," Mr. Christiana said, noting that he and Mr. Frankel don't agree on much policy-wise.

"However, I am convinced that the consolidation of hospitals and doctors' offices and the power of large health care providers demands that the government put safety nets in place to protect the interests of all Pennsylvanians. ... We must protect the access for our constituents."

The contract between Highmark and UPMC expires at the end of 2014; if the two don't arrive at a new contract before then, many Highmark customers won't have in-network access to UPMC doctors and hospitals.

It's not clear if the legislation will gain broader support, or if the effort will be seen as merely a regional issue that's of little concern to other parts of the state. Currently, there is no companion legislation in the Senate.

"It's not just about Western Pennsylvania, it's not just about Highmark, and UPMC, and the Allegheny Health Network, and the UPMC Health Plan," Mr. Frankel said Wednesday.

"This is about a trend that is taking place and will continue to take place. We have two integrated delivery networks in Western Pennsylvania, and another one in Geisinger [Health System] in the middle of the state. ... This is a trend that is taking place along with the consolidation of hospitals and physician practices. If it's not in your neighborhood now, it's coming soon," he said.

House Majority Leader Mike Turzai, R-Bradford Woods, did not show much enthusiasm for the proposal when questioned by reporters Wednesday.

"Now, we think there is appropriate competition on the provider side and appropriate competition on the insurance side and really ... many folks believe now just to let that play out," he said.

UPMC officials have said the legislation would make Pennsylvania alone among states to pass such a requirement, which would harm competition among insurers.

The Insurance Federation of Pennsylvania, which represents leading national insurers (and UPMC Health Plan), said the proposal shows "Highmark is again looking for the government to help it perpetuate its monopoly. That's what this bill is all about -- not protecting consumers or giving them good choices and competition for health insurance."

A spokesman for the Hospital & Healthsystem Association of Pennsylvania said the organization also opposes the bills because they "will result in unfair competition. ... In addition, we do not believe the mandatory arbitration process called for by either bill is feasible."

state - health

Kate Giammarise: kgiammarise@post-gazette.com, 1-717-787-4254 or on Twitter @KateGiammarise. Karen Langley contributed.


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