PENNSYLVANIA SUPREME COURT RULING ON PITTSBURGH AND ERIE AREA HIGHMARK MEDICARE ADVANTAGE HOSPITAL CONTRACTS WITH UPMC
Today, the Pennsylvania Supreme Court reversed the Pennsylvania Commonwealth Court’s ruling that supported Highmark Medicare Advantage Security Blue HMO and Freedom Blue PPO members’ in-network access to UPMC hospital in Pittsburgh and Erie through 2019.
The new ruling now allows UPMC to terminate Pittsburgh and Erie area Highmark Medicare Advantage hospital contracts at the end of 2018.
Highmark’s Medicare Advantage Security Blue HMO and Freedom Blue PPO members will continue to have in-network access to all UPMC hospitals including those in Pittsburgh and Erie through December 31, 2018, and do not need to take any action at this time.
There is no change for Highmark’s Community Blue Medicare HMO and PPO or Medigap Blue members with this ruling. Highmark’s Medigap supplemental insurance has no network. All Medicare Part B participating providers must bill and accept Medigap insurance products for their Medicare patients.
Key Messages to Share with your Clients:
-
Highmark is committed to doing what is best for our members.
-
We have a long history of offering a broad range of products for our Medicare members including both in-network and out-of-network benefits to meet their unique needs.
-
We will continue to work on developing new options to help ensure access to local health care providers and while traveling.
-
Members are encouraged to contact Highmark directly during the Medicare Annual Enrollment period
Please review the Talking Points for conversations with your clients.
If you have any questions, please contact your Highmark Client Manager or Sales Executive. |
