Attorney General Shapiro Praises Court Ruling Guaranteeing Medicare Advantage Coverage for Estimated 140,000 UPMC Patients in Western PA

January 29, 2018 | Topic: Consumers

HARRISBURG — In a court ruling prompted by a case filed by Attorney General Josh Shapiro, a Commonwealth Court judge today ordered UPMC to continue providing in-network care to an estimated 140,000 Medicare Advantage patients in Western Pennsylvania through the end of 2019.

The ruling by Senior Judge Dan Pellegrini approved a petition filed by the Office of Attorney General, which stated that Medicare Advantage patients insured through Highmark Health should be able to receive in-network care at nine UPMC hospitals through December 30, 2019.  UPMC had taken the position that it could stop treating these patients at in-network rates on June 30, 2019, the expiration date for the 2014 consent decree agreements between the two parties spelling out the terms for how UPMC and Highmark will end their relationship.

Judge Pellegrini’s 14-page decision ensures Highmark-insured patients on Medicare Advantage will still be able to see their UPMC doctors at in-network rates through the end of 2019.

“This court ruling helps protect Western Pennsylvanians’ health care coverage and simplifies patients’ lives,” Attorney General Shapiro said. “The decision today will save consumers money, provide them stability to keep seeing their regular physicians at the same in-network rates through the end of 2019, and give them time to explore future coverage options.”

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