AG Kane Stepping in After UPMC Threatens to Shut Out Medicare Advantage Customers
"The latest dispute became public two weeks ago when it was revealed that UPMC is threatening to lock Highmark’s 182,000 Medicare Advantage customers out of its hospitals starting Jan. 1, 2016."
"After UPMC sent Highmark a notice of nonrenewal in February about the Medicare Advantage access, UPMC told the state it would follow through on the threat to keep those 182,000 seniors with that policy out of its hospitals unless Highmark agreed to increase cancer payments to UPMC and drop a lawsuit related to those payments."
"The cancer payment issue has been brewing for a year after Highmark said last April that it would no longer pay UPMC certain “markups” for cancer care that UPMC provided in outpatient centers, rather than in doctors’ offices."
"Medicare, the federally subsidized health program for people age 65 and older, allows hospitals to receive higher fees for certain procedures when they are done in outpatient clinics, rather than in doctors’ offices."
Read more at:
http://www.post-gazette.com/news/health/2015/04/25/Kane-taking-UPMC-Highmark-consent-decree-dispute-to-court/stories/201504250078
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