2011-07-14 / Local & State

UPMC Wants Talks On Divorce With Highmark

PITTSBURGH (AP) – The University of Pittsburgh Medical Center says it wants to talk to Highmark Inc. to negotiate a “smooth, seamless transition’’ from its contract with the region’s dominant health insurer, a newspaper reported.

The Pittsburgh Tribune- Review said Sunday that it had obtained a letter dated Friday in which UPMC’s top lawyer said it’s time for the two nonprofits to talk about winding down contracts that expire at the end of June of next year.

After that, the medical center’s 2,700 doctors will be out- of-network for Highmark’s 3 million members in western Pennsylvania. Most of the center’s 19 hospitals will remain in the Highmark network for another year.

Tom McGough Jr., UPMC’s senior vice president and chief legal officer, said the medical center wants to negotiate over such matters as continuing Medicare and Medicaid coverage, availability of specific UPMC facilities or physicians during any transition period, protocols for transfer of medical records and guidelines for handling cases of ongoing treatment or other hardship, the paper said.

Highmark spokesman Michael Weinstein declined comment Friday on the letter, saying he had not seen it, and reiterated Highmark’s position that the insurer hoped to negotiate a reasonable contract renewal.

McGough said in his letter that that will not happen now that Highmark has announced plans to assume control of the ailing West Penn Allegheny Health System, which runs Allegheny General Hospital in Pittsburgh. The insurer said last month that it will spend $475 million in the proposed takeover of the region’s second largest hospital system.

“It is absolutely clear that there will be no renewal or extension of the contracts placing UPMC hospitals and physicians in Highmark’s network,’’ McGough wrote.

But Jan Jennings, president of the Pittsburgh consulting firm American Healthcare Solutions, said it’s still too early to say the companies will not work out some sort of agreement.

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