A $240 million UPMC hospital in Monroeville, Pa., will be out of network to Highmark members when it opens in July after the insurer refused UPMC's request to sign a one-year contract for Highmark members, according to a Pittsburgh Tribune-Review report.
Highmark declined the offer yesterday. The development reflects a change in the payor-provider relationship, since Highmark had asked UPMC to resume contract negotiations for months.
UPMC had originally threatened to terminate contracts with Highmark in 2012, given the payor's pending acquisition of Pittsburgh competitor West Penn Allegheny Health System. In December, UPMC and Highmark reached an agreement to extend those contracts until June 30, 2013, but Highmark said it would continue to pursue long-term contracts with the provider.
Highmark Senior Vice President Deborah Rice said, "We don't think talking about one facility makes any sense without a long-term contract," according to the report. She also said the agreement made in December only covered UPMC facilities that were operational and open at that time.
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Highmark declined the offer yesterday. The development reflects a change in the payor-provider relationship, since Highmark had asked UPMC to resume contract negotiations for months.
UPMC had originally threatened to terminate contracts with Highmark in 2012, given the payor's pending acquisition of Pittsburgh competitor West Penn Allegheny Health System. In December, UPMC and Highmark reached an agreement to extend those contracts until June 30, 2013, but Highmark said it would continue to pursue long-term contracts with the provider.
Highmark Senior Vice President Deborah Rice said, "We don't think talking about one facility makes any sense without a long-term contract," according to the report. She also said the agreement made in December only covered UPMC facilities that were operational and open at that time.
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