Expressing the Sense of the Council of Allegheny County supporting the actions of Attorney General Kathleen G. Kane, Acting Secretary of Health, Dr. Karen Murphy, and Acting Insurance Commissioner, Teresa D. Miller in their efforts to enforce the consent decree between Highmark Inc. and UPMC and to request arbitration through the Commonwealth Court.
WHEREAS, both Highmark Inc. and UPMC submitted separate Consent Decrees which were approved by the Commonwealth Court on July 1, 2014 in settling a Petition for Review that Commonwealth of Pennsylvania had filed; and
WHEREAS, as part of these Consent Decrees, it was mutually agreed that UPMC shall continue to contract with Highmark at In-Network rates for all of the vulnerable populations that included Highmark consumers age 65 or older who are eligible or are covered under Medicare Advantage; and
WHEREAS, on March 20, 2015 UPMC notified Highmark that UPMC will terminate all of its Highmark Medicare Advantage hospital and physician contracts with Highmark effectively depriving 182,000 seniors who have Highmark Medicare from its hospitals starting next year in direct contravention of the Consent Decrees; and
WHEREAS, this decision by UPMC to terminate all of its Highmark Medicare Advantage hospital and physician contracts was based upon a contract dispute over reimbursements for cancer treatment; and
WHEREAS, the decision by UPMC to terminate services to Medicare Advantage customers prompted Pennsylvania Attorney General Kathleen Kane, with backing from Governor Tom Wolf and the state insurance department, to file a motion to try to force the two health care giants into binding arbitration; and
WHEREAS, Pennsylvania Governor Tom Wolf stated, "I will not allow our most vulnerable citizens, especially seniors, to be used as pawns in the dispute between UPMC and Highmark. UPMC's decision to cancel Medicare Advantage for over 180,000 seniors was the final straw after my administration's repeated attempts to resolve differences in good faith. After reviewing all options with the Office of Attorney General, the Commonwealth has decided to pursue this matter in court to protect seniors;" and
WHEREAS, this Council emphatically agrees with the Governor’s statements on this issue and it is the opinion of this Council that UPMC should honor the consent decrees and not deny any senior citizen who is insured under Highmark Medicare Advantage access to any UPMC hospital or physician; and
WHEREAS, this Council sees the steps that Attorney General and Governor have done in trying to compel arbitration between as a positive move forward to a more definite resolution to a dispute that has the potential to negatively impact thousands of the most vulnerable citizens, our seniors;
NOW THEREFORE, IT IS MOVED, THAT THE COUNCIL OF ALLEGHENY COUNTY,
Supports the actions of the Attorney General and the administration of Pennsylvania Governor Tom Wolfe in their efforts to have the Commonwealth Court enforce the Consent Decree and compel binding arbitration between Highmark Inc. and UPMC in order to protect all the citizens of Allegheny County, but especially our most vulnerable population, which are our senior citizens.
PRIMARY SPONSOR: COUNCIL MEMBER KRESS