Pennsylvania court says UPMC-Highmark consent decrees end June 30

Pittsburgh
The consent decrees between the University of Pittsburgh Medical Center and Highmark Health are set to end this month. (Getty/Joecho-16)

A Pennsylvania appeals court has ruled that the government-brokered deal between the University of Pittsburgh Medical Center (UPMC) and Highmark Health will end as scheduled June 30. 

Commonwealth Court Judge Robert Simpson ruled (PDF) Friday that the state’s attorney general and Highmark had failed to “state a cause of action for the extension of the termination/expiration provision of the consent decrees” with UPMC. 

The state’s Supreme Court asked the lower court to decide the case at the end of May. Attorney General Josh Shapiro said on Twitter, however, that the Commonwealth Court’s ruling doesn’t mean the case is over. His office will announce “subsequent legal actions” next week, Shapiro tweeted

Free Daily Newsletter

Like this story? Subscribe to FierceHealthcare!

The healthcare sector remains in flux as policy, regulation, technology and trends shape the market. FierceHealthcare subscribers rely on our suite of newsletters as their must-read source for the latest news, analysis and data impacting their world. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.

“Make no mistake—our work here is not done,” Shapiro said in a post. “While we are disappointed in the court’s ruling today, I am not quitting on the people of western Pennsylvania.” 

RELATED: UPMC spikes controversial ‘prepay’ policy for Highmark MA members 

The Commonwealth Court had previously determined that the consent decree would end this month, leading to the Supreme Court appeal. A second appeal is likely. 

UPMC and Highmark’s bitter rivalry dates back nearly a decade and began in earnest in 2011 when Highmark purchased what is now Allegheny Health Network to challenge UPMC directly in the provider space. 

The state intervened in the deal, forming the consent decrees at the heart of the ongoing legal battle. These agreements kept Highmark and UPMC provider services in each other’s health plan networks for five years, but they expire this month. 

In an effort to extend this arrangement, Shapiro filed suit against UPMC in February, alleging it was failing to meet its charitable obligations, with the goal of pushing it into a new, modified version of the consent decrees. Highmark backs the modified plan as well. 

UPMC Spokesman Paul Wood said in a statement that the healthcare giant is “pleased” with the court’s ruling. 

“UPMC is grateful the Commonwealth Court expeditiously reached this decision,” Wood said. “We look forward to continuing to fulfill our long-standing charitable mission and serving the public with UPMC’s world-class physicians and facilities.” 

Suggested Articles

Humana filed suit Friday against more than a dozen generic drugmakers alleging the companies engaged in price fixing.

Ochsner Health System is partnering with Color to launch a population health pilot program to integrate genetic information into preventive care.

Medicare Advantage open enrollment kicked off last week, and insurers are taking new approaches to marketing a slate of supplemental benefit options.