Every resident of western Pennsylvania will be able to use UPMC hospitals after its contract with health insurer Highmark expires in 2015, with the vast majority of the population having in-network network access, Chief Legal Officer W. Thomas McGough testified Wednesday.
“Clearly, anyone who wants access to UPMC will have it when the current contracts expire,” he said at a hearing before the Pennsylvania House Committee on Health in Harrisburg, according to prepared remarks. “In western Pennsylvania, we are the clear provider of choice and draw our patients from all over the world.”
The hearing was conducted on legislation that requires big hospital systems like UPMC to accept patients regardless of insurance coverage, while prohibiting excessive charges for care. Reps. Dan Frankel, D-Squirrel Hill, and Jim Christiana, R-Beaver, sponsored the two companion bills. A second public hearing on the legislation is anticipated early next year in Pittsburgh.
The bills would end a simmering contract dispute between Highmark and UPMC by allowing more than a million Highmark members to have in-network and, therefore, lower cost access to UPMC hospitals after the contract expires.
Highmark President and CEO William Winkenwerder argued in support of the bills, saying the state has a responsibility to guard against “out of control market power” caused by hospital consolidation. Consolidation among doctors and hospitals is expanding statewide.
“Out of control market power due to provider consolidations is not confined to one region in the state,” he said, according to prepared remarks. “While the impact is currently being felt more acutely by residents in western Pennsylvania, there is no doubt that other regions in the state will soon experience the anti-consumer effects of provider consolidations.”
Date: Dec 18, 2013