PA Judge Rules UPMC Must Continue Providing In-Network Services to Highmark Medicare Advantage Plan Members

On May 29, 2015, a Pennsylvania judge ruled that UPMC must continue to provide in-network services to members of Highmark’s Medicare Advantage plans per the consent decree reached between the two organizations last year.

The judge also said UPMC and Highmark must go to arbitration if they can’t resolve several other outstanding issues, and that they cannot make any changes to any plan, contract, or other business relationship between the two, no matter how small, without first securing approval from the court.

According to several media reports, a UPMC spokesman said in a statement that it would be appealing the decision to the Pennsylvania Supreme Court.

As the contract between the two expired Dec. 31, 2014, patients may still have questions such as “What does it mean for me?” “How will it impact my access to care?” “Can I keep my doctor?” and “Will I have to pay more for services?”

Information and guidance is available on a website designed to help consumers navigate the changes at www.stayinformed.pa.gov.