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Longtime Highmark patient Virginia Eskridge of Shadyside, left, speaks with Attorney General Josh Shapiro during a celebratory event hosted by the Pennsylvania Health Access Network following the announcement of new ten year contract between UPMC and Highmark , Monday, at the United Steelworkers building Downtown.
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AG Shapiro cites patients' personal stories as force behind UPMC-Highmark agreement

Jessie Wardarski/Post-Gazette

AG Shapiro cites patients' personal stories as force behind UPMC-Highmark agreement

Attorney General Josh Shapiro returned to Pittsburgh on Monday to meet with a roomful of patients, one week after he and Gov. Tom Wolf announced a 10-year agreement ending the UPMC-Highmark contract dispute that itself lasted nearly a decade.

“You saved my life, really,” said Evie Bodick of Springdale, a cancer survivor.

“I’m grateful for what you’ve done,” enthused Virginia Eskridge, a Shadyside resident.

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Mr. Shapiro, who came to the one-hour session at the United Steelworkers Building, Downtown, at the invitation of the Pennsylvania Health Access Network advocacy group, returned the praise.

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“It was really your voices that I heard throughout this whole process,” he told the 30 or so attendees.

Mr. Shapiro then recounted the two-year effort by his office to convince Pittsburgh health giants Highmark and UPMC to extend the five-year consent decree agreement that gave Highmark insurance members some access to UPMC facilities and doctors.

He and a team of 20 attorneys in his office worked many hours on legal strategy, he said, but his personal inspiration came from meetings with people he’d met walking Pittsburgh streets.

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“They said, ‘I’m really frustrated by this health care situation. Can you do something about it?’”

While Highmark officials agreed to the attorney general’s proposal to extend the consent decrees, UPMC would not. That prompted Mr. Shapiro to file a lawsuit in February alleging that by limiting access to its network, UPMC had not met its obligations as a charitable organization.

A Commonwealth Court ruling on June 14 agreed with UPMC that the consent decrees would expire June 30.

But, days before that decision, Mr. Shapiro had made clear that — regardless of how the court ruled — his office intended to pursue questions regarding UPMC’s relationship with the University of Pittsburgh, the use of charitable assets by UPMC President and CEO Jeffrey Romoff, as well as the conduct of individual UPMC board members.

Pennsylvania Attorney General Josh Shapiro announces an agreement between UMPC and Highmark on Monday. At right is Gov. Tom Wolf.
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He reiterated Monday that the new agreement does not change his intention to continue to aggressively enforce the state’s public charity laws.

At the same time, Mr. Shapiro told one attendee that his authority does not extend to changing existing collective bargaining or commercial contracts, which may offer narrow network plans at reduced cost.

Both Highmark and UPMC, for example, offer insurance plans that limit or block access to competing networks. Those restrictions remain in place. More than 300,000 Western Pennsylvania members of Community Blue plans, for example, will not have in-network access to most UPMC doctors and hospitals.

“It’s a choice people make,” Mr. Shapiro said.

That means that, while it appears federal officials will authorize a special enrollment period for Medicare Advantage members to switch plans in light the of UPMC-Highmark pact, the commercial insurance market may take a few years to sort out as each network adjusts its yearly offerings.

Mr. Shapiro struck an optimistic tone about the long-term prospects for local health care consumers.

“I do believe there’s a new day here,” he said. “I think there’s an opportunity to do something really great in this region.”

Steve Twedt: stwedt@post-gazette.com or 412-263-1963.

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First Published: July 1, 2019, 10:13 p.m.

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Longtime Highmark patient Virginia Eskridge of Shadyside, left, speaks with Attorney General Josh Shapiro during a celebratory event hosted by the Pennsylvania Health Access Network following the announcement of new ten year contract between UPMC and Highmark , Monday, at the United Steelworkers building Downtown.  (Jessie Wardarski/Post-Gazette)
Judy Hays of Crescent Twp., center, waves at Attorney General Josh Shapiro as he arrives at a celebratory event hosted by the Pennsylvania Health Access Network following the announcement of new ten-year contract between UPMC and Highmark, Monday, July 1, 2019, at the United Steelworkers building Downtown.)  (Jessie Wardarski/Post-Gazette)
Attorney General Josh Shapiro, left, speaks with Joe Bodick of Springdale, second from left, his wife Evie Bodick, second from right, and Judy Hays of Crescent Twp., righ.  (Jessie Wardarski/Post-Gazette)
Maria Montano of Beechview, left, shakes hands with Attorney General Josh Shapiro, right.  (Jessie Wardarski/Post-Gazette)
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