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06/17/2021 08:11 PM
Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=H&SPick=20210&cosponId=34354
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House of Representatives
Session of 2021 - 2022 Regular Session

MEMORANDUM

Posted: January 25, 2021 09:53 AM
From: Representative Dan Frankel
To: All House members
Subject: Expanding Fair Access to Hospital Care
 
Integrated delivery networks' (IDNs) unique ability to pay themselves for health care delivery allows them to unfairly manipulate the marketplace to their advantage and, worse, the practice creates terrible problems for sick and vulnerable Pennsylvanians. For example, a hospital system could charge its own health plan $30,000 for a hip replacement, and charge competing insurance companies $45,000. They can make their own insurance products less expensive to consumers because other insurance companies must pay more for the same services. These contracts are private; consumers never know they are paying more. As we’ve seen from the UPMC/Highmark issue in Western Pennsylvania, IDNs can make it impossible for consumers who choose their competitor’s insurance plan to get care at all.  
 
Hospitals and medical providers that are considered purely public charities especially should not be able to deny care in order to get a competitive advantage. They should not be able to subsidize their own insurance plans – selling them cheaper – by having their hospital system charge their competitors more than they charge themselves. 
 
In 2019, the Attorney General filed a lawsuit based on the Pennsylvania Constitution’s provision for “Purely Public Charities” requiring that UPMC provide patients access and negotiate fairly. Our legislation goes one step further – it avoids the long legal battles and confusion by clarifying the law to include a requirement that IDNs fairly contract with all insurance companies – to make sure patients don’t get caught in the middle. 
 
As these IDNs grow by purchasing independent hospitals around the state, protecting access to healthcare and creating a fair healthcare marketplace for Pennsylvanians seeking treatment is essential. Please join us by cosponsoring these important pieces of legislation. 



Document #1

Description: The first bill creates a system for fair contracting with hospital systems that are part of integrated delivery networks. 
 

Document #2

Description: The second bill creates a system for fair contracting with provider networks employed by integrated delivery networks.