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Court Validates Highmark Medicare Plan that Excludes UPMC
Highmark Inc. won a court ruling Thursday allowing it to exclude UPMC hospitals and doctors from some plans it sells to seniors.
Highmark Inc. won a court ruling Thursday allowing it to exclude University of Pittsburgh Medical Center (UPMC) hospitals and doctors from some plans it sells to seniors.
Commonwealth Court President Judge Dan Pellegrini denied a request by Attorney General Kathleen Kane and Gov. Tom Corbett's administration to hold Highmark in contempt of a consent decree the state's largest health insurer signed this summer.
Highmark said it will continue selling the Community Blue Medicare Advantage plans, which are less expensive alternatives to broad-network Highmark plans for seniors that include full in-network access to UPMC, the biggest hospital network in Western Pennsylvania.
Read more: http://bit.ly/1BuFf2n
Price Transparency With Gaps: Assessing the Completeness of Payer Transparency in Coverage Data
December 9th 2025In analyzing 2025 Transparency in Coverage (TIC) files from national insurers, the authors found vast payer-level differences; overall, physician/outpatient data were more complete, and hospital inpatient data were less complete.
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