Play Live Radio
Next Up:
0:00
0:00
0:00 0:00
Available On Air Stations

Highmark To Pay Claims Filed By UPMC Since Jan. 1

Highmark has agreed to pay the approximately 30,000 outstanding medical claims filed by UPMC providers and facilities since January 1.

Gov. Tom Wolf called it a “major win” for patients. 

“My focus is protecting consumers caught in the dispute between Highmark and UPMC, and I have urged both companies to do the same,” Wolf said.

A statement from Highmark spokesman Aaron Billgher cited the close cooperation with the governor and Actor Insurance Commissioner Teresa Miller.

“Working together, we agree that it’s important to put people first so they don’t get caught in the middle when the information necessary to pay claims isn’t provided by UPMC,” Billgher said.

The announcement ensures that consumers will not be billed for the difference in rates for “out of network” care.

UPMC spokesman Paul Wood issued a statement in response to the announcement.

“UPMC is grateful Gov. Wolf and Insurance Commissioner Miller worked diligently to resolve this dispute and provide much-needed clarity for our patients.

Last week the Wolf administration and the Office of the Attorney General filed a motion in Commonwealth Court to protect more than 180,000 seniors from losing access to their physicians as a result of UPMC’s decision to cancel its Medicare Advantage contract with Highmark claiming Highmark was seriously behind on its payments to the hospital system for cancer care. Highmark believes it was over-charged.

The administration’s motion also petitioned the court to force UPMC and Highmark into arbitration to settle outstanding disputes to end the confusion for consumers.

“Looking ahead, we will continue to work with the Commonwealth and it is our hope that UPMC will join us in putting the interests of patients and consumers first so that we can avoid litigation,” the statement from Highmark concluded.