Pennsylvania court rules UPMC-Highmark consent decree will end June 30 News
© WikiMedia (Doug Kerr)
Pennsylvania court rules UPMC-Highmark consent decree will end June 30

The Commonwealth Court of Pennsylvania ruled Wednesday that a consent decree allowing Highmark members in-network access to UPMC facilities in Western Pennsylvania will end June 30.

The ruling comes after UPMC filed a motion to dismiss in response to a petition filed in February by Pennsylvania Attorney General (OAG) Josh Shapiro. In the petition, Shapiro alleged that UPMC shirked its duties as a public charity and sought an extension and modifications to the consent decree to rectify the issues. Extending the consent decree would allow members from either insurance company to continue to use the other company’s hospital facilities.

UPMC responded to the petition with a motion to dismiss, claiming:

(1) OAG’s claims are barred as a matter of law because they are released, forfeited, or unripe; (2) the Petition wrongfully seeks to modify the Consent Decree to regulate UPMC beyond the Consent Decree’s expiration date; (3) the Petition must be dismissed because OAG is proceeding without the proper parties; and (4) the requested modifications exceed OAG’s powers to regulate nonprofit entities.

The court agreed with UPMC that the consent decree could not be extended:

Nevertheless, there is one prayer for modification … that cannot be granted by this Court: the prayer that the Court extend the duration of a modified Consent Decree indefinitely … [O]ur Supreme Court has already decided that the June 30, 2019 termination date is an unambiguous and material term of the Consent Decree. That Court also instructed that in the absence of fraud, accident or mistake, courts have neither the power nor the authority to modify or vary the terms set forth.

The court denied the rest of UPMC’s motion to dismiss and allowed OAG’s petition to continue.