Attorney General requests extension of controversial UPMC-Highmark agreement

Dillon Carr | Friday, April 26, 2019 2:16 p.m.

The UPMC and Highmark buildings in Downtown Pittsburgh.

The attorney general’s office has asked the state Supreme Court to temporarily extend the soon-to-expire agreement between Pittsburgh health care rivals Highmark and UPMC, saying it would be impossible to settle the long-simmering dispute before June 30.

Attorney General Josh Shapiro’s filing on Wednesday said there is not enough time for the Commonwealth Court to consider the office’s efforts to change the 2014 agreement, which allow thousands of Highmark health insurance members to be treated by UPMC doctors and hospitals at in-network rates. The consent decrees expire June 30.

UPMC has not responded to Shapiro’s filing and declined to comment for this story.

The move, essentially made to earn Shapiro’s office more time to overhaul the consent decrees, came the same day a judge in the U.S. District Court for the Middle District of Pennsylvania dismissed a UPMC lawsuit that challenged Shapiro’s authority to modify the consent decrees.

“To allow UPMC to achieve victory by delay at the expense of hundreds of thousands of vulnerable Pennsylvanians would, in effect, violate the Commonwealth’s right to have its petition to modify heard at all,” Shapiro said in the court filing.

The attorney general reiterated in the brief that the 2014 consent decrees between the health care rivals contains a “modification provision” that allows anyone to modify the consent decree if it is in the public’s interest.

“There is nothing sacrosanct about the end date of the consent decree,” he said in the filing.

Shapiro said that a Commonwealth Court’s April 3 decision that ruled the consent decrees cannot be changed or extended indefinitely was an error and has appealed to the state Supreme Court.

Arguments on the appeal are scheduled May 16 in Harrisburg.

“Even with the court’s expedited briefing and argument schedule, it would be impossible for the Commonwealth Court to proceed to a final judgment on merits (before June 30),” Shapiro said in the brief.

Therefore, the attorney general requested the state Supreme Court to extend the end date of the consent decrees “until the courts have reached a final, unappealable decision on its petition for modification.”

Shapiro has argued that thousands of Highmark health insurance members would suffer financially and medically if they lose access to UPMC doctors and hospitals.

Among other demands, Shapiro asked in a Feb. 7 legal petition that UPMC hospitals and doctors to accept Highmark patients “in perpetuity” and drop a controversial prepay rule.