Lawmakers want Pa. hospitals to contract with 'any insurer'

Legislators do not want another UPMC-Highmark

Two Pennsylvania state legislators are proposing bills that would require hospitals to contract with "any willing insurer," in the wake of contentious fallout between regional health giants Highmark and UPMC, the Pittsburgh Post-Gazette reports.

Background on the Highmark-UPMC deal

In May of 2012, the two integrated health systems agreed to an 18-month deal, after a year of intense negotiation during which Pennsylvania Gov. Tom Corbett (R) assigned a health executive to mediate the contract talks.

Seeking to resolve the standoff, Highmark also pursued legislation that would have forced UPMC into binding arbitration by the state insurance commissioner.

As of now, most Highmark insurance plan customers will not have access to UPMC doctors and hospitals when their deal expires in 2014.

Details of the proposed legislation

The yet-to-be introduced legislation seeks to impose contracts between insurers and hospitals through binding arbitration, "if a mutually agreeable contract cannot be reached," according to the Post-Gazette.

"By requiring hospitals and physicians operating as part of an integrated delivery network to contract with all insurers, consumers will not be denied care, or worse abandoned mid-treatment, simply because they hold one type of insurance over another," a memo about the legislation states, adding that "all consumers should be afforded access to these vital hospital and physician services, regardless of which insurance card they carry."

The co-sponsors of the legislation—Dan Frankel (D) and Jim Christiana (R)—discussed the proposal at a press conference this week even as the Affordable Care Act's state health insurance exchanges launched.

"When you have a system trying to limit access, I think that's a concern," Frankel said, adding that although the two legislators do not agree on about 90% of politics, they agree on this legislation.

"I see that as evidence that this is an issue that kind of rises above partisanship," Frankel said, adding that it is "access" and "about how health care is financed."

Although the memo regarding the legislation does not mention UPMC by name, it does refer to "hospitals operating as part of an integrated delivery network."

UPMC spokesperson Paul Wood said that "[r]equiring anybody to contract with everybody is exactly the opposite of the insurance competition that every employer and every consumer in Western Pennsylvania wants" (Giammarise, Pittsburgh Post-Gazette, 10/2).

Next in the Daily Briefing

How much will hospitals get paid in the exchanges? About the same

Read now