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Patients, activists urge Pa. lawmakers to halt UPMC-Highmark divorce

Natasha Lindstrom
| Tuesday, May 14, 2019 6:49 p.m.
Natasha Lindstrom | Tribune-Review
Erin Ninehouser (left), spokeswoman for the Pennsylvania Health Access Network advocacy group, and Vicki Arnett (center), whose husband is a cancer patient from Western Pennsylvania, and Allegheny County Controller Chelsa Wagner (second from right) were among several speakers during a May 14, 2019 rally in Harrisburg calling for urgent legislative intervention in the looming UPMC-Highmark divorce. Arnett’s husband is traveling to Atlanta for cancer treatments because as of July 1 his Highmark insurance will be considered out-of-network at most UPMC facilities, including the Hillman Cancer Center.

HARRISBURG — East Deer resident Brittany Eckert plans to reluctantly say goodbye to the oncology team she credits with saving her life when she sees them Wednesday morning, her final appointment at UPMC Magee-Womens Hospital.

Soon, her insurance card will not be accepted there unless courts intervene.

“It’s a really scary thing, and I feel that this is something that the Supreme Court, all the legislative people, they need to look at this and say, ‘OK, what if I was in their shoes? What if it was me?’ ” said Eckert, 32, who was diagnosed with a rare form of uterine cancer at age 29.

Beth McCracken of Pittsburgh’s Brookline neighborhood laments that she, too, is about to lose access to UPMC doctors. She lost one ear and continues to receive treatment for the possible re-emergence of a rare ear cancer.

“I shouldn’t have to drive two hours to Cleveland when I can see the best doctors 20 minutes from my house,” McCracken said. “I shouldn’t have to establish all new doctor relationships. The idea of being cut off from my current doctors is terrifying to me.”

On Tuesday afternoon, days before a critical Supreme Court hearing on the issue, Eckert and McCracken participated in a rally to protest UPMC’s policies. They were joined at the state Capitol Rotunda in Harrisburg by patients and family members, activists organized by labor and health care advocacy groups in Pittsburgh, a handful of state lawmakers and Allegheny County Controller Chelsa Wagner.

Both women rely on Highmark insurance coverage provided by their spouses’ benefits plans and have been told they must sever ties with UPMC doctors to avoid a prepayment rule for out-of-network patients set to go into effect at most UPMC hospitals July 1.

They say that amid their circumstances, switching to a UPMC-backed plan would not only be cumbersome but much more costly.

Speakers rebuked UPMC and its controversial prepay rule while lauding efforts by Attorney General Josh Shapiro to halt the looming breakup between the insurance networks of UPMC and its Pittsburgh-based nonprofit rival, Highmark. They called on the General Assembly to act on legislation intended to “protect patient access.”

“What we’re seeking to do is make sure that any nonprofit hospital (or) entity will accept any insurance — or they should not have their not-for-profit, ‘purely public charity’ designation,” Wagner said.

Several dozen rally participants, including Wagner, boarded a bus from Pittsburgh to Harrisburg on Tuesday morning, then split into groups to meet with lawmakers and their representatives in the Capitol.

Wagner presented lawmakers with a copy of a petition with more than 10,000 signatures from people in Western Pennsylvania urging legislative intervention.

“These giant nonprofits must remember that it was our tax dollars and our charitable contributions that enabled them to buy all these doctors and hospitals, and shame on them for taking our money and turning their backs on us now that we need them,” McCracken said. “We are fast approaching the eleventh hour in this situation. Our elected officials have the ability to fix this. Our lives depend on them doing the right thing.”

State Reps. Dan Frankel and Tony DeLuca spoke at the rally in support of companion legislation, House Bills 1211 and 1213 and Senate Bills 310 and 311, intended to begin putting rules in place to govern nonprofit health systems in the name of protecting patient access.

“We need to take back our hospitals,” said DeLuca, D-Penn Hills.

Frankel, D-Squirrel Hill, accused UPMC, Pennsylvania’s largest nongovernment employer, of “calling the shots and using hardball tactics to rule the market with patients left feeling like collateral damage.”

During a visit to the office of state House Speaker Mike Turzai, R-Allegheny, activists requested that House GOP leaders expedite the legislation for a vote, Wagner said. It’s unclear whether there is legislative momentum to do so.

A showdown looms this week in state Supreme Court to decide whether Shapiro’s efforts to force changes on UPMC by altering a 5-year-old, state-brokered agreement can go on.

UPMC argues in court filings that Shapiro is flouting prior court rulings, usurping lawmakers and violating state and federal laws in a politically charged, misguided quest to single-handedly reshape how health care works. The health system further accuses Shapiro of siding with its rival, Highmark, over the public good.

On Thursday, Supreme Court justices will hear arguments from both sides and be tasked with resolving a critical dispute in the matter: whether the expiration date of the 2014 consent decree between UPMC and Highmark can be changed or at least put on hold while broader legal and legislative efforts play out.

As it stands, the decree is set to expire June 30.


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