Medical markups: Highmark and UPMC must pare excess bills

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Highmark’s decision to reject price markups — consumers call it price gouging — on some oncology-related services is a victory for health care customers, particularly individuals and employers who buy health insurance.

The region’s dominant health insurer should not stop there, though. It needs to examine other categories of medical treatment that may be subject to overcharges.

The Highmark announcement last week followed a report by the Post-Gazette on Feb. 16 in which a Butler man who had undergone outpatient chemotherapy in 2012 was charged $2,545 at Johns Hopkins Hospital in Baltimore, then $13,790 for the same treatment two weeks later at UPMC Passavant.

Highmark’s chief medical officer said such costly markups have been “growing uncontrollably” and could amount to $200 million a year from assorted health care providers. All health insurers, not just Highmark, must refuse to cover padded bills.

Sadly, the quoted response from a UPMC spokesman was not “We will work with all of our insurers to eliminate such overcharges,” but rather it “would be an egregious contract violation for Highmark to attempt to unilaterally change fee schedules.”

UPMC and Highmark are spending millions of dollars to win the hearts and minds of Pittsburghers. Shouldn’t they instead be working together to cost us less?


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