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Bills Would Allow State to Step In on UPMC/Highmark Dispute

Democratic lawmakers from Allegheny County are introducing legislation to increase the state's influence in insurance contract disputes, a move that would allow the Corbett administration to intervene in the UPMC/Highmark contract battle.

State Representative Tony DeLuca (D-Penn Hills) said his bill would permit the Pennsylvania Insurance Commissioner to terminate, create, or continue insurance contracts when he sees fit.

Health care provider UPMC and health insurer Highmark have walked away from contract renewal negotiations. The current contract expires in July of 2012.

DeLuca said the state doesn't usually interfere with contentions between private entities, but this case is different.

"This isn't just a matter of choosing a brand of soda pop to drink here," said DeLuca. "People's lives are dependent on their health care remaining accessible and affordable to them."

Legislators are worried that Highmark customers would no longer have access to the facilities of UPMC, the largest health care provider in the area. Lawmakers are especially concerned that some patients would be forced to pay exorbitant amounts to see doctors at UPMC's specialized facilities.

State Representative Dan Frankel (D-Pittsburgh) has introduced a measure to address that concern.

"We would take the four specialty hospitals [in Pittsburgh] out of the UPMC vise by making certain that any insurer can have access to them," said Frankel. "Western Psychiatric Institute, Magee Women's Hospital, Children's Hospital, and the Hillman Cancer Center and the Cancer Network."

State Senator Jay Costa (D Forest Hills) promised that upcoming Senate legislation would mirror the House bills.

The legislators said they weren't taking sides in the contract dispute between nonprofit UPMC and insurer Highmark, but repeatedly mentioned the former's $3 billion surplus and aggressive business tactics.