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State steps into Highmark-UPMC dispute again with FAQs

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The Pennsylvania Insurance Department cannot force the University of Pittsburgh Medical Center health care system and Pittsburgh-based insurer Highmark Inc. to enter into a commercial contract.

So instead, PID has posted a list of frequently asked questions designed to help consumers understand the tension-ridden health care situation in western Pennsylvania.

Highmark is a major player in the Central Pennsylvania insurance market, and its acquisition of West Penn Allegheny Health System has drawn much attention because close relationships between providers and payers may well be the future face of health care. The acquisition has also sparked much advertising by Highmark and UPMC, and confusion over whether Highmark patients will be able to see UPMC physicians.

In August, Gov. Tom Corbett issued a statement urging Highmark and UPMC to maintain a focus on their higher social mission; requiring them to clarify any consumer confusion; and announcing the creation of an interagency task force to monitor the ongoing communications and maintain the state’s role in protecting consumers.

PID and the Pennsylvania Department of Health issued a joint news release announcing the posting of the FAQs.

“While we recognize Highmark’s and UPMC’s legitimate right to compete in the market, they may not do so at consumers’ expense nor at the expense of fair and accurate information,” Insurance Commissioner and Interagency Consumer Task Force Co-Chairman Michael Consedine said. “With these FAQs, consumers can evaluate the information presented by UPMC and Highmark on access to providers and costs of care,” Secretary of Health and Task Force Co-Chairman Michael Wolf said. “Our goal is to make sure consumers have a place to go in order to make informed healthcare decisions.”

The agencies said the task force will continue to review the advertisements running on television and in print in western Pennsylvania to determine whether the information is potentially misleading, confusing, inaccurate or incomplete.

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