Regulators, Highmark spell out post-UPMC plan

PITTSBURGH (AP) — Officials with health insurer Highmark Inc. and the Pennsylvania Insurance Department have spelled out a plan for Highmark customers to continue using doctors from the rival University of Pittsburgh Medical Center once Highmark’s provider agreement with UPMC ends Jan. 1.

Highmark contends 80 percent of UPMC’s doctors can still serve Highmark subscribers at in-network rates after the split, a claim UPMC spokesman Paul Wood disputes.

Highmark said UPMC doctors who provide services at UPMC hospitals outside the five-county greater Pittsburgh region, or who also do some work at non-UPMC hospitals will be considered in-network — meaning they’ll be cheaper to use — for Highmark subscribers.

But Wood contends the 80 percent number is “grossly exaggerated.” He says more than 40 percent of UPMC’s doctors shouldn’t be considered “in-network” providers for Highmark.