Highmark, the largest insurer in
In its lawsuit, Highmark alleges UPMC has inflated the prices of chemotherapy treatments that were provided at physicians' offices by charging for the services as if they were provided at hospital outpatient clinics. UPMC has allegedly engaged in the improper billing practices since 2010.
The lawsuit is the latest development in a longstanding dispute between Highmark and UPMC. In 2011, Highmark announced it would acquire bankrupt West Penn Allegheny Health System — one of UPMC's largest competitors — in an attempt to maintain the viability of a lower-cost competitor to UPMC.
After the insurer announced the acquisition, UPMC said it would not renew its contract with Highmark, saying the contract would benefit a direct rival. The contract between the two organizations was set to expire at the end of 2014.
In June, after much negotiation between the parties, Pennsylvania Governor Tom Corbett (R) announced UPMC and Highmark had entered into a five-year transition agreement.
However, since the agreement was announced there has been a string of controversy surrounding the contract, including a dispute over the terms of the contact, causing lawmakers to question the deal.
In addition, Highmark released its post-UPMC transition plan this week, which UPMC is already contesting.
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