Community Blue is an attractive Highmark option because of its lower costs, but subscribers knew there was no UPMC access and this agreement will not suddenly open up the doors of UPMC. 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. Highmark CEO David Holmberg says consumers are the winners: “Individuals, employers and groups can choose coverage based on their needs.” Not at all. We focus on doing what is right for our members and the community. Competition in the health sector will help reduce costs, quality and innovation in care. 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. The two systems sign a five-year agreement, known as the “approval regulation,” in the hope of facilitating the transition for patients. October 30, 2014 – National health care and insurance supervisors are trying to keep Highmark in contempt for the introduction of a Monthly Premium Plan for Medicare Advantage 0, which explicitly excludes UPMC institutions.
Commonwealth Judge Dan Pellegrini rejected the state`s request. November 30, 2015 – The Pennsylvania Supreme Court has ruled that Highmark Medicare Advantage members should have access to UPMC until at least June 30. July 2019, 2018 – The state Supreme Court ruling that networked access to UPMC and Highmark will end in mid-2019 for Medicare Advantage.Oct patients. 1, 2018 – UPMC announces that after the impending split, patients insured at Hautemark are subject to a prepayment rule in most UPMC facilities. Highmark is asking UPMC to reconsider this issue.