Neishloss& Fleming Inc.

UPMC East, a new 156 bed facility in Monroeville which is scheduled to open in July 2012, will not be available to Highmark members.  In a statement, Highmark has refused UPMC’s request to sign a one year contract to allow Highmark members to utilize the facility as an in-network provider.

Highmark has taken the position that in the absence of a long term agreement, for which they have been seeking negotiations with UPMC, that it does not make sense to add UPMC East for one year.  While some think that the motivation may be Forbes Regional Hospital, which is owned by West Penn Allegheny Health System, others believe this may be Highmark trying to utilize the new hospital opening to drive UPMC back to the bargaining table for a new comprehensive network agreement.

It appears that mediation between Highmark, UPMC, and state officials have produced some results.  As written in the Pittsburgh Tribune-Review this morning, the two health care companies have announced an extension in their contract until June 30, 2013.

The positioning around the extension, however, is being portrayed differently by both companies.  UPMC characterizes the extension simply as a way for “subscribers to review the multiple competitive health insurance options now  available to assure that their care will continue uninterrupted with UPMC  physicians and hospitals”.  Highmark’s position is that they will “continue to work toward achieving a long-term contract with UPMC that  guarantees our members affordable access to all UPMC hospitals and physicians  and preserves provider choice”.

You can read the full article on the extension on the Tribune-Review website.

The Pittsburgh Tribune-Review, in an article by Alex Nixon, is reporting that the Pennsylvania state Senate Banking and Insurance Committee voted unanimously to send a measure to the full Senate which would give the Insurance Department “more power to intervene in contract disputes  between health insurers and hospital systems”.

This is of note due to the ongoing contract dispute between Highmark & UPMC.  UPMC has steadfastly refused to negotiate a new contract with Highmark, citing Highmark’s involvement with the West Penn Allegheny Health System as competition.

This new bill, if passed as written, “would give the insurance commissioner authority to extend physician contracts  and delay the end of both types of contracts by up to 36 months”.

You can read the full article on the Pittsburgh Tribune-Review’s website.