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Federal Judge Tosses UPMC's Lawsuit Against PA Attorney General

Gene J. Puskar

U.S. District Court Judge John E. Jones has dismissed a federal lawsuit that UPMC filed against Pennsylvania Attorney General Josh Shapiro.

UPMC, western Pennsylvania’s largest health system, took this legal action to block Shapiro's effort to extend a consent decree between UPMC and its competitor, Highmark. In February, Shapiro filed a lawsuit in state court to continue the agreement, which requires each health care company to accept insurance coverage provided by the other.

The acrimony between the two rivals began in 2011 when Highmark, then the region's largest insurance company, acquired its own health care system. This put Highmark in direct competition with UPMC, which until then was the region's only provider of both health care and insurance. 

In the now-dismissed complaint, UPMC argued that Shapiro was attempting an unconstitutional regulatory takeover by forcing it to contract with Highmark. But Judge Jones wrote that, “UPMC faces no threat of enforcement” because the state court had yet to rule, andthere have been no laws passed that would force UPMC to accept Highmark insurance.

A spokesperson for the attorney general’s office said the district court’s ruling was “a strong win.” UPMC declined to comment.

A portion of Shapiro's case is set to come before the Pennsylvania Supreme Court next month. Justices will rule whether to allow the patients with Highmark insurance to continue receiving in-network care from UPMC while the legal battle in state court continues.

WESA receives funding from UPMC and Highmark.

Sarah Boden covers health and science for 90.5 WESA. Before coming to Pittsburgh in November 2017, she was a reporter for Iowa Public Radio. As a contributor to the NPR-Kaiser Health News Member Station Reporting Project on Health Care in the States, Sarah's print and audio reporting frequently appears on NPR and KFF Health News.