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Ahead of consent decree hearing, UPMC says Highmark members won't lose access to Hillman Cancer Center

Pennsylvania attorney general says UPMC is trying a 'last-minute ploy' before court hearing on consent decree

Ahead of consent decree hearing, UPMC says Highmark members won't lose access to Hillman Cancer Center

Pennsylvania attorney general says UPMC is trying a 'last-minute ploy' before court hearing on consent decree

REPORTER A HILLMAN CANCER CENTER PATIENT WE SPOKE WITH IS HAPPY AND RELIEVED AT THE NEWS ABOUT IN NETWORK ACCESS FOR HIM TO THAT CENTER, BUT HE STILL FEELS THERE SHOULD BE ACCESS AND NETWORK FOR EVERYONE AT ALL UPMC FACILITIES. >> IT’S A GREAT HOSPITAL. I HAVE NOTHING B TREMENDOUS CARE FROM THEM. THEY’VE KEPT ME ALIVE FOR ALMOST FOUR YEARS NOW AND I’M TRULY GRATEFUL TO THEM. REPORTER: HILLMAN CANCER CENTER IS A LIFE-SAVER FOR CHUCK COLLETTI, WHO WAS DIAGNOSED SEVERAL YEARS AGO WITH NON-HODGKINS LYMPHOMA. AFTER CHEMO, REMISSION AND THE CANCER COMING BACK HE ENTERED A , CUTTING EDGE CLINICAL TRIAL OF CELL THERAPY THAT’S HELPED HIM. HE FACES TESTS AND CHECKS EVERY THREE MONTHS -- AND CAN FACE HOSPITALIZATION WHEN HE GETS SERIOUS INFECTIONS OR HIGH FEVER. UPMC’S ACCESS DECISION WILL BENEFIT HIM, BUT HE’S NOT GIVING UP ON SUPPORTING IN-NETWORK ACCESS FOR ALL PATIENTS AT ALL OF UPMC. >> I ALSO BELIEVE THAT THEY’RE A CHARITABLE HOSPITAL, AND THEY SHOULD BE OPEN TO ALL PEOPLE. WHETHER THEY HAVE CANCER OR NOT, TO BE ABLE TO COME IN AND USE IT REPORTER: WITH THEIR INSURANCE. REPORTER:-- USE IT WITH THEIR INSURANCE. REPORTER: HE SAYS IT WOULD BE SELFISH OF HIM TO FEEL OTHERWISE, EVEN IF HE’LL PERSONALLY HAVE THE ACCESS HE NEEDS. >> MY LIFE CHANGED FOUR YEARS AGO, AND I REALIZED THAT LIFE IS BIGGER THAN JUST ME. SO I TRY TO MAKE A DIFFERENCE, I TRY TO LEAVE A FOOTPRINT, SO FOR ME, IT IS WHAT IS FAIR IS FAIR. REPORTER: COVERING THE DISPUTE OVER THE UPMC HIGHMARK STATE CONSENT DECREES, BOB M
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Ahead of consent decree hearing, UPMC says Highmark members won't lose access to Hillman Cancer Center

Pennsylvania attorney general says UPMC is trying a 'last-minute ploy' before court hearing on consent decree

UPMC's announcement that its Hillman Cancer Center will still be available at in-network rates for people with Highmark health insurance after a court consent decree expires at the end of June is a relief for patients affected."It's been frustrating, and, for us, a lot of anxiety, not knowing. And of course, the decision about being able to continue to use Hillman was a relief to a lot of people. Because at the end of the day, this not just about changing your family doctor. This is about life and death for a lot of people," Chuck Colletti, a UPMC Hillman Cancer Center patient with Highmark insurance, told Pittsburgh's Action News 4.Colletti of North Huntingdon, Westmoreland County, was diagnosed several years ago with non-Hodgkin lymphoma. He was treated by UPMC for seven months of chemotherapy, then was in remission for seven months then it came back. A couple of years ago, UPMC accepted him in a cutting-edge clinical trial of CAR T-Cell therapy that's helped him.He faces tests and data collection every few months but can face hospitalization at UPMC if he gets a serious infection or high fever. UPMC's access decision will benefit him but he's not giving up on supporting in-network access for all patients at all hospitals and programs of UPMC."That would be a very selfish thing for me to do or think. And anyone that knows me knows that I advocate for Leukemia Lymphoma Society, I advocate for a lot of different causes right now. My life changed four years ago, and I realized that life is bigger than just me. So I try to make a difference, I try to leave a footprint. So for me it's what's fair is fair," Colletta said."UPMC is a great hospital, I've had nothing but tremendous care from them. They've kept me alive for almost four years now and I'm truly grateful to them," Colletta said. "I also believe that they're a charitable hospital, and they should be open to all people. whether they have cancer or not, to be able to come in and use it with their insurance."Court consent decrees between UPMC, Highmark and the state of Pennsylvania run out at the end of June. Court fights over whether to force an extension are continuing down to the wire.Thursday, UPMC announced that, even if you carry a Highmark insurance card, you'll still have access to UPMC Hillman Cancer at agreed-on in-network rates. Tap the video player above to watch the report on the announcement. "This is a very good positive day for the community, for UPMC and for Highmark's members who are our patients," Paul Wood, UPMC VP & chief communications officer, told Pittsburgh's Action News 4 Thursday. Asked how long the access policy will last, Wood answered, "From now on, going forward, this will last as long as Highmark wants it to last."The announcement about access to the UPMC Hillman Cancer Center came following a meeting between UPMC President and CEO Jeffrey Romoff, Allegheny County Executive Rich Fitzgerald, and Pittsburgh Mayor Bill Peduto.Wood said similar arrangements for access to UPMC Children's Hospital and Western Psychiatric Institute and Clinic were already provided for under the consent decree.Pennsylvania Attorney General Josh Shapiro said Thursday he's glad to hear the news but he says the relief he's seeking in court goes beyond what he calls a "coordinated last-minute ploy" which he claims UPMC could rescind at any moment."We're going to bill Highmark directly for at current in-network rates for their members to come to UPMC Hillman for all their cancer and cancer related care," Wood said.Highmark says it needs to secure written contract language about what UPMC is now telling the public about access to UPMC Hillman Cancer Center.Asked by Pittsburgh's Action News 4 if UPMC is open to new contract language that locks in the access forever, Wood responded, "We will be sending Highmark a term sheet, which is a contract. We hope Highmark will engage in good faith negotiations and we hope Highmark will accept our offer for what it is."All Hillman locations will continue to be available "at currently agreed upon in-network rates" after the consent decree ends on June 30, UPMC said in a post on its website.Tap here to read the full statement.The announcement comes just days before a Commonwealth Court judge will hear arguments on a petition by the Pennsylvania Attorney General's Office to keep the UPMC-Highmark consent decree in place beyond June 30.On Wednesday, UPMC said it was dropping a controversial policy that would have required Highmark Medicare Advantage members to prepay for services after the end of the consent decree.Governor Tom Wolf spoke with Pittsburgh's Action News 4 while in Greensburg Thursday."As groups converge and consolidate we’re going to have to figure this out so I’m heartened that they’re making this progress," Wolf said. "The attorney general is taking a harsher course and maybe that’s had some impact in getting the two sides to work more closely together. I don’t know, but this is a good thing for all of us."While Attorney General Josh Shapiro said he was pleased by the recent UPMC announcements, he also accused the health care organization of trying to pull a "last-minute ploy" before it goes to court with him next week.Highmark spokesman Aaron Billiger said the insurer is ready to work with UPMC and Shapiro "if UPMC is willing to work in good faith." He added that Highmark will need contract language from UPMC to confirm the recent care commitments.____Statement from Attorney General Josh Shapiro:"I'm glad UPMC has finally made these welcome concessions to open vital taxpayer-funded institutions to all Western Pennsylvanians, as my office has repeatedly asked them to do for more than two years."Instead of agreeing previously, UPMC chose to wait until the 11th hour -- just before we are scheduled to meet in court on Monday -- to finally commit to providing the care that its doctors and nurses do so ably at these specialty hospitals to all patients."Schoolchildren, seniors, workers, police in Allegheny County and Pittsburgh are still not getting their fair share and they are still restricted from UPMC care based on the insurance card they carry, and UPMC is still violating Pennsylvania's charities laws."The relief we seek in court goes well beyond this coordinated last-minute ploy, which UPMC could rescind at any moment and leave patients without care."We look forward to making our case in court next week."Statement from Highmark:"In order to memorialize what UPMC has said to the public about access to Hillman Cancer Care and to protect Highmark health plan members and patients, we need to secure contract language and agreements so that their practices align with their commitments. UPMC, Highmark and the Pennsylvania Attorney General -- who has jurisdiction over all charitable, nonprofit organizations -- are in litigation, and everything needs to be reviewed by the attorney general. We look forward to working with the attorney general and UPMC, if UPMC is willing to work in good faith."

UPMC's announcement that its Hillman Cancer Center will still be available at in-network rates for people with Highmark health insurance after a court consent decree expires at the end of June is a relief for patients affected.

"It's been frustrating, and, for us, a lot of anxiety, not knowing. And of course, the decision about being able to continue to use Hillman was a relief to a lot of people. Because at the end of the day, this not just about changing your family doctor. This is about life and death for a lot of people," Chuck Colletti, a UPMC Hillman Cancer Center patient with Highmark insurance, told Pittsburgh's Action News 4.

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Colletti of North Huntingdon, Westmoreland County, was diagnosed several years ago with non-Hodgkin lymphoma. He was treated by UPMC for seven months of chemotherapy, then was in remission for seven months then it came back. A couple of years ago, UPMC accepted him in a cutting-edge clinical trial of CAR T-Cell therapy that's helped him.

He faces tests and data collection every few months but can face hospitalization at UPMC if he gets a serious infection or high fever. UPMC's access decision will benefit him but he's not giving up on supporting in-network access for all patients at all hospitals and programs of UPMC.

"That would be a very selfish thing for me to do or think. And anyone that knows me knows that I advocate for Leukemia Lymphoma Society, I advocate for a lot of different causes right now. My life changed four years ago, and I realized that life is bigger than just me. So I try to make a difference, I try to leave a footprint. So for me it's what's fair is fair," Colletta said.

"UPMC is a great hospital, I've had nothing but tremendous care from them. They've kept me alive for almost four years now and I'm truly grateful to them," Colletta said. "I also believe that they're a charitable hospital, and they should be open to all people. whether they have cancer or not, to be able to come in and use it with their insurance."

Court consent decrees between UPMC, Highmark and the state of Pennsylvania run out at the end of June. Court fights over whether to force an extension are continuing down to the wire.

Thursday, UPMC announced that, even if you carry a Highmark insurance card, you'll still have access to UPMC Hillman Cancer at agreed-on in-network rates.

Tap the video player above to watch the report on the announcement.

"This is a very good positive day for the community, for UPMC and for Highmark's members who are our patients," Paul Wood, UPMC VP & chief communications officer, told Pittsburgh's Action News 4 Thursday. Asked how long the access policy will last, Wood answered, "From now on, going forward, this will last as long as Highmark wants it to last."

The announcement about access to the UPMC Hillman Cancer Center came following a meeting between UPMC President and CEO Jeffrey Romoff, Allegheny County Executive Rich Fitzgerald, and Pittsburgh Mayor Bill Peduto.

Wood said similar arrangements for access to UPMC Children's Hospital and Western Psychiatric Institute and Clinic were already provided for under the consent decree.

Pennsylvania Attorney General Josh Shapiro said Thursday he's glad to hear the news but he says the relief he's seeking in court goes beyond what he calls a "coordinated last-minute ploy" which he claims UPMC could rescind at any moment.

"We're going to bill Highmark directly for at current in-network rates for their members to come to UPMC Hillman for all their cancer and cancer related care," Wood said.

Highmark says it needs to secure written contract language about what UPMC is now telling the public about access to UPMC Hillman Cancer Center.

Asked by Pittsburgh's Action News 4 if UPMC is open to new contract language that locks in the access forever, Wood responded, "We will be sending Highmark a term sheet, which is a contract. We hope Highmark will engage in good faith negotiations and we hope Highmark will accept our offer for what it is."

All Hillman locations will continue to be available "at currently agreed upon in-network rates" after the consent decree ends on June 30, UPMC said in a post on its website.

Tap here to read the full statement.

The announcement comes just days before a Commonwealth Court judge will hear arguments on a petition by the Pennsylvania Attorney General's Office to keep the UPMC-Highmark consent decree in place beyond June 30.

On Wednesday, UPMC said it was dropping a controversial policy that would have required Highmark Medicare Advantage members to prepay for services after the end of the consent decree.

Governor Tom Wolf spoke with Pittsburgh's Action News 4 while in Greensburg Thursday.

"As groups converge and consolidate we’re going to have to figure this out so I’m heartened that they’re making this progress," Wolf said. "The attorney general is taking a harsher course and maybe that’s had some impact in getting the two sides to work more closely together. I don’t know, but this is a good thing for all of us."

While Attorney General Josh Shapiro said he was pleased by the recent UPMC announcements, he also accused the health care organization of trying to pull a "last-minute ploy" before it goes to court with him next week.

Highmark spokesman Aaron Billiger said the insurer is ready to work with UPMC and Shapiro "if UPMC is willing to work in good faith." He added that Highmark will need contract language from UPMC to confirm the recent care commitments.

____

Statement from Attorney General Josh Shapiro:

"I'm glad UPMC has finally made these welcome concessions to open vital taxpayer-funded institutions to all Western Pennsylvanians, as my office has repeatedly asked them to do for more than two years.

"Instead of agreeing previously, UPMC chose to wait until the 11th hour -- just before we are scheduled to meet in court on Monday -- to finally commit to providing the care that its doctors and nurses do so ably at these specialty hospitals to all patients.

"Schoolchildren, seniors, workers, police in Allegheny County and Pittsburgh are still not getting their fair share and they are still restricted from UPMC care based on the insurance card they carry, and UPMC is still violating Pennsylvania's charities laws.

"The relief we seek in court goes well beyond this coordinated last-minute ploy, which UPMC could rescind at any moment and leave patients without care.

"We look forward to making our case in court next week."

Statement from Highmark:

"In order to memorialize what UPMC has said to the public about access to Hillman Cancer Care and to protect Highmark health plan members and patients, we need to secure contract language and agreements so that their practices align with their commitments. UPMC, Highmark and the Pennsylvania Attorney General -- who has jurisdiction over all charitable, nonprofit organizations -- are in litigation, and everything needs to be reviewed by the attorney general. We look forward to working with the attorney general and UPMC, if UPMC is willing to work in good faith."