Judge Rules Highmark's Medicare Patients Get UPMC In-Network Coverage Through 2019

Jan 29, 2018

Highmark’s Medicare costumers can continue receiving in-network care from nine UPMC hospitals until the end of 2019, due to a Monday ruling by Commonwealth Court Senior Judge Dan Pellegrini.

UPMC had argued that like others with Highmark insurance, people with Highmark’s Medicare Advantage plans should stop receiving this care in July of 2019.

Medicare is a federal health insurance program for people 65 and older. Some 140,000 people in western Pennsylvania have coverage through the program.

Attorney General Josh Shapiro argued successfully on behalf of Highmark that Medicare patients should get longer access from UPMC.

“I’m especially happy for the more than 140,000 seniors in western Pennsylvania who are going to have greater predictability in their health care, have access in their health care, and be able to control their costs for longer,” said Shapiro.

90.5 WESA was unable to reach UPMC for comment, but officials with UPMC told other news outlets it intends to appeal.

Earlier this month, the two companies reached a separate five-year agreement allowing Highmark customers to receive in-network care from select UPMC facilities after June 30, 2019.