Attorney General Josh Shapiro Announces Legal Action Against UPMC for Violating Pennsylvania’s Charities Laws
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- Petition to modify Consent Decrees aims to restore fairness and promote the public interest in western
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Attorney General
"Our petition today has a simple goal: to restore fairness to the healthcare system in western
In 2014, the
The petition filed by Attorney General Shapiro specifically asks the Commonwealth Court to:
* Enable open and affordable access to UPMC's health care services and products through negotiated contracts with any health plan;
* Require last, best-offer arbitration - commonly known as "baseball arbitration" - when contract negotiations between insurers and providers fail; and
* Protect against UPMC's unjust enrichment by prohibiting excessive and unreasonable billing practices inconsistent with its status as a non-profit charity providing healthcare to the public.
"Given the effect this dispute between UPMC and Highmark is having on Pennsylvanians, and the imminent expiration of the existing consent decree, we are asking the court to take action," said Shapiro. "These changes are absolutely necessary to prevent UPMC from inflicting further harm on the public by forsaking its charitable obligations in pursuit of commercial success."
Even operating under the current consent decree agreement, a legal review by the
* Withholding access to doctors for patients in
* Refusing to negotiate reasonable payment terms with self-insured employers, resulting in UPMC's unjust enrichment through excess reimbursements for the value of its services.
UPMC operates as a public, non-profit charitable institution in the
"As a public charity, especially one enjoying perpetual tax-exempt status, UPMC must behave in a manner consistent with its charitable mission in all facets of its operation," continued Attorney General Shapiro. "By law, it is a give-and-take relationship between UPMC and Pennsylvanians, and UPMC is taking more than its fair share from taxpayers."
During the press conference, Attorney General Shapiro told the story of a woman who was a first responder in
More than a dozen individuals with similar stories of uncertainty and frustration stood behind the Attorney General at today's press conference. Two women from the
Attorney General Shapiro concluded by saying, "UPMC has an obligation to the people of
For more information on today's announcement, please click here (https://www.attorneygeneral.gov/upmc).
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