Pennsylvania
Related: About this forumAG Kane Stepping in After UPMC Threatens to Shut Out Medicare Advantage Customers
"The latest dispute became public two weeks ago when it was revealed that UPMC is threatening to lock Highmarks 182,000 Medicare Advantage customers out of its hospitals starting Jan. 1, 2016."
"After UPMC sent Highmark a notice of nonrenewal in February about the Medicare Advantage access, UPMC told the state it would follow through on the threat to keep those 182,000 seniors with that policy out of its hospitals unless Highmark agreed to increase cancer payments to UPMC and drop a lawsuit related to those payments."
"The cancer payment issue has been brewing for a year after Highmark said last April that it would no longer pay UPMC certain markups for cancer care that UPMC provided in outpatient centers, rather than in doctors offices."
"Medicare, the federally subsidized health program for people age 65 and older, allows hospitals to receive higher fees for certain procedures when they are done in outpatient clinics, rather than in doctors offices."
Read more at:
http://www.post-gazette.com/news/health/2015/04/25/Kane-taking-UPMC-Highmark-consent-decree-dispute-to-court/stories/201504250078
blue neen
(12,335 posts)Now UPMC is threatening the elderly and ignoring the Consent Decree.
It's time for our elected officials to do something about it. Kudos to AG Kane.
mrmpa
(4,033 posts)he has brought nothing but ruin to the healthcare system in Pennsylvania. Is his name Romoff or Romanoff (I can't stand him, so I keep forgetting his name). He even spoke at my college graduation, the President of my alma mater is on the UPMC Board of Directors. I even emailed her and asked that she remove herself from this board.
Also no health insurance company should own hospitals, and no hospitals should have their own insurance company. this is just plain wrong.
blue neen
(12,335 posts)Curmudgeoness
(18,219 posts)It is way beyond time to split that up. I can't even figure out how it got to this and who allowed it.
Just plain wrong.
femmocrat
(28,394 posts)I am glad she is working diligently for these patients, in spite of her own legal problems.