Posted: | May 4, 2015 03:58 PM |
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From: | Representative Anthony M. DeLuca |
To: | All House members |
Subject: | Codifying the UPMC Consent Decree with an Administrative Solution |
In the near future I will be introducing legislation expanding the Insurance Commissioner’s powers to regulate the current state of relations between UPMC and Highmark-UPE. In June of 2014 a consent decree was signed by UPMC with the Commonwealth and by Highmark-UPE with the Commonwealth. Vulnerable populations were supposed to be protected and guaranteed in-network access to UPMC until 2019. The populations included Medicare, Medicaid and CHIP. Now, UPMC is attempting to eliminate in-network access to Highmark Medicare Advantage customers beginning in January 2016. Parties also agreed to protect oncology patients and those are currently in a continuity-of-care situation. Most recently, the Attorney General had to file in court on behalf of the Pennsylvania Insurance and Health departments, as well as the A.G.’s office, to attempt to remedy this situation, but the clock is ticking. Therefore, due to continued arguments between the parties, I feel it is now necessary to find an administrative solution to provide the Insurance Commissioner with a remedy, instead of watching issue after issue head before the courts to be refereed. Although a consent decree was signed by each party and the Commonwealth in June of 2014, we continue to see bickering at the expense of our constituents in western Pennsylvania. This fall is open enrollment season for seniors who are eligible for Medicare, so we have no time to waste. Please join me in co-sponsoring this important and timely legislation. If you should have any questions please contact my office at 717-787-4437. |
Introduced as HB1172