Rep. Christiana: Legislature needs ‘guts to stand up to’ rivals UPMC, Highmark
The
Christiana lamented that "patients are at the mercy of these companies unless the Legislature puts permanent solutions in place."
"The health care landscape is rapidly changing, and our public policy needs updated to protect patients from the market being dominated by a few organizations," Christiana said. "I hope my colleagues are sick and tired of having their constituents leveraged for market share, because I've been tired of it for a while."
Beginning
The prepay requirement clashed with assurances from Highmark that members of two of its 2019 Medicare Advantage Plans --
The uncertainty has flooded local senior enrollment helplines with calls from thousands of Western Pennsylvanians questioning whether they can keep their doctors once the consent decree ends next summer.
"These situations occur when tax-exempt nonprofits run their organizations like Fortune 500 companies, and the Legislature doesn't have the guts to stand up to them," Christiana said in his statement.
Highmark is asking UPMC to reconsider and bill Highmark directly "like they always have" and like all other out-of-network providers typically do.
Christiana did not elaborate on any specific legislative fixes he intends to support.
Patients started observing the effects of this region's changing landscape shortly after
UPMC said it wouldn't contract with an organization that owned competing hospitals.
Christina helped lead the bipartisan legislative push that resulted in the state-mediated consent decree in 2014 to govern relations between UPMC and Highmark until 2019.
The two giants have since squabbled and fought in court as each expands its reach across the state and nation.
"We can't have insurance companies leveraging their hospitals and their doctors to play this high-stakes poker game, locking certain people out based on the insurance card in their wallet," Christiana said in 2013, when he tried unsuccessfully to pass a pair of "healthcare marketplace fairness" bills.
The proposed legislation would have required physicians and hospitals within integrated delivery networks that have provider and insurer arms operating under the same corporate umbrella -- including UPMC,
At the time, UPMC criticized the so-called "any willing" legislation as unprecedented "coercion" that would result in "select and narrow networks to minimize expenses and coordinate care, and would impose yet another layer of state government intervention and price control in the health care marketplace."
Christiana and Frankel's pair of bills introduced in 2013 garnered more than 40 co-sponsors but died before making it to a vote on the House floor.
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