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October 12, 2000

Agreement allowing some Pitt employees to retain certain Highmark doctors is finalized

A deal allowing Pitt employees who are subscribers to the UPMC Health Plan to retain certain Highmark doctors has been finalized.

University Senate President Nathan Hershey announced the deal at the Oct. 10 Senate Council meeting. Hershey, who had been critical of the delay in reaching the agreement, said he hoped this resolved the matter.

Ronald Frisch, associate vice chancellor for Human Resources, said that Pitt had received notification of the signed agreement between the two health insurers that day.

Under the contract addendum, about 1,000 UPMC Health Plan subscribers at Pitt (approximately 600 employees and their covered dependents) are eligible to use doctors in Highmark's Alliance Ventures/Premier Medical and Alliance Medical practice groups — about 120 physicians in all — if they were patients of the physicians between July 1, 1999, and June 30, 2000. (See University Times, Sept. 14.) Pitt's contract with Highmark expired June 30. On July 1, a three-year, sole-provider deal with UPMC Health Plan went into effect. The contract limited Pitt health care subscriber options to UPMC Health Plan selections.

But Highmark officials agreed with UPMC Health Plan officials to allow Pitt patients and their covered dependents to continue seeing Highmark physicians in the two designated medical practice groups.

Spokespersons for UPMC Health Plan and the Highmark medical practice groups confirmed the agreement.

Frisch said that while the amendment has not been extended for the life of the three-year Pitt-UPMC Health Plan contract, he is optimistic that such an extension will be reached. He said that on Sept. 13, representatives of the two sides got together with him and other Pitt officials and reached an understanding. "I believe Lee Bowser [chief operating officer of the Highmark medical practice groups] is personally committed [to extend this] for the life of our contract with UPMC Health Plan," Frisch said.

Attempts to work out such an amendment have prompted charges in recent weeks as to which side was delaying a settlement. Senate President Hershey told Faculty Assembly Oct. 3 that according to his information, the two insurers had reached a verbal agreement on this amendment on June 16. He said that by mid-August, frustrated with what appeared to him to be an impasse, he took "matters into my own hands as best I could." (See Sept. 14 University Times.) "Now, it may be that Pitt was negotiating with the UPMC [Health Plan] people to get them to negotiate with Highmark, but to the best of my knowledge there were no negotiations between UPMC [Health Plan] and Highmark during this time," Hershey told Faculty Assembly.

Jerome Cochran, executive vice chancellor, said in a Sept. 28 letter to the University Times that the "major impediment to progress" was Highmark.

Medical practice plans' COO Bowser disputed Cochran's evaluation of the negotiations, saying that Hershey's description of the sequence of events was correct. (See letters, page 3.)

–Peter Hart

 

Filed under: Feature,Volume 33 Issue 4

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