Highmark Transition Plan Approved by State Department of Insurance

On Sept. 2, Highmark’s final transition plan — issued to assist and inform consumers as the contract between Highmark and UPMC is set to expire on Dec. 31, 2014 — was approved and posted to the Pennsylvania Department of Insurance’s website. The goal of the plan, which will be implemented immediately by Highmark, is to minimize patient confusion about access to UPMC facilities and physicians.

Highmark also has established a website to assist patients in determining whether their physician is participating in a Highmark network.

The transition plan highlights elements such as provider networks, affordable access, continuation of care, and a communication plan meant to keep clients and members informed.

There are some remaining unresolved issues that are still being negotiated. The Pennsylvania Medical Society (PAMED) and Allegheny County Medical Society (ACMS) will continue to keep physicians informed. We also are analyzing the plan and will include updates in future communications on what it means for Pennsylvania physicians and patients.

The finalization of the transition plan follows extensive work of a task force assigned by Gov. Corbett and led by Insurance Commissioner Mike Consedine and Department of Health Secretary Michael Wolf.

Earlier this summer, the Corbett administration set up a cabinet level leadership team to meet with and facilitate discussions between UPMC and Highmark to avoid disruption of care before the looming Dec. 31 deadline of their contract agreement. On June 23, Gov. Corbett and other state officials announced that they had helped broker an updated agreement between the two insurers on patient transition and services.

“Highmark’s transition plan, which was submitted late in July, underwent intensive financial and legal review which focused on consumer concerns,” Insurance Commissioner Mike Consedine said in a press release. “We will continue to be focused on consumers and will seek to provide clear information as well to hold Highmark to the elements of their plan.”

“The final plan specifically outlines the process for safeguarding consumers’ health care and minimizing any patient disruption,” Department of Health Secretary Michael Wolf said.