HighmarkHealthServicesUpdate

TALKING POINTS REGARDING UPMC AND MEDICARE ADVANTAGE PARTICIPATION

Last week, the media reported that UPMC has informed Highmark it will not participate in our Medicare Advantage offerings for 2016.  
 
This action by UPMC is a violation of the consent decree, signed with the Commonwealth of Pennsylvania last year. UPMC's action is intended to force Highmark to withdraw litigation against UPMC related to irrational oncology drug billing practices that cost our members and employer customers tens of millions of dollars annually.  
 
To be clear, this change in billing practices is totally administrative, offers absolutely no clinical or quality difference to cancer patients and, in some cases, leads to price increases from the same doctor and facility of 200 to 400 percent.
 
Because we are standing up to UPMC on our customers' behalf, UPMC is now threatening the seniors of our region, and its actions are unconscionable.
 
Highmark supports the response of the Governor and the Attorney General, who are calling for litigation if UPMC does not reverse course and meet its obligation to continue to serve senior citizens.
 
We look forward to the legal process moving quickly, and it is our intention to continue to work closely with the Commonwealth.
 
We will keep you updated on this issue. If you have any questions, please contact your Highmark client manager. And, as always, we appreciate your continued partnership to provide quality health care coverage for your clients.
Download the talking points regarding UPMC and Medicare Advantage participation.