Upmc Ahn Agreement
The 10-year contract allows UPMC and Highmark to reserve the right to develop additional plans that exclude the other, as long as each patient has access to at least one plan that includes access to both systems. Pennsylvania Attorney General Josh Shapiro announced Monday that the two rivals had reached an agreement after spending two years negotiating with the two health systems to prevent the end of their multi-year approval orders. After months of legal back-and-forth, the University of Pittsburgh Medical Center and Highmark have reached an agreement that would extend network coverage for UPMC facilities to Highmark members for the next decade. “Without this agreement, millions of patients – including the elderly, cancer patients and working mothers – would have abruptly ended their care,” Shapiro said in a statement. “Thanks to the patients who told their stories about what they had to lose, Western Pennsylvanians now have access to a fair health care system that is assured for the next decade.” Highmarks The purchase of what is now AHN in 2011 has seriously triggered the rivalry, leading state officials to intervene and mitigate. The result was a five-year contract that provides both network coverage at the other provider`s facilities. What is the impact of the Highmark and UPMC agreement on Medicare Advantage? Currently, UPMC has only coverage agreements with Jefferson Hospital in Pleasant Hills and St. Vincent d`Erie Hospital. A UPMC spokesperson said the agreement does not require Highmark to include UPMC in all insurance products.
But if it contains UPMC, it must include all UPMC physicians, hospitals and services, and Highmark members do not charge more a-pocket to go to UPMC than highmarks allegheny Health Network or other network providers. Will this new agreement change the way UPMC Health Plan does business? No no. UPMC Health Plan will continue to develop innovative, high-quality insurance products for consumers in western Pennsylvania and across the Commonwealth. We continue to strive to provide all UPMC hospitals and providers, as well as many hospitals and municipal providers, with exceptional service and comprehensive network access. UPMC-Highmark TimelineJun 2011 – Highmark announces plans to expand beyond insurance activities by acquiring the former West Penn Allegheny Health System. The base of Highmark`s supplier arm, Allegheny Health Network.May 2012 – UPMC and Highmark enter into a mediation agreement to obtain in-network access for patients by December 31, 2014.27 June 2, 2014, Gov. Tom Corbett and the district attorney`s office intervened after Highmark and UPMC failed to agree on a contract.