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Highmark Takes Huge Financial Hit on ACA Exchange Plans

The federal health exchange hasn’t been kind to Highmark Health. After losing $318 million on health plans sold to exchange consumers, the Pittsburgh-based company reported a total operating loss of...

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Highmark v. UPMC Dispute Heard by Pa. Supreme Court

UPMC has kept Highmark Medicare Advantage members in-network, as ordered by a Pennsylvania Commonwealth Court judge on May 29, but an appeal to the state’s Supreme Court could still shift the market in...

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UnitedHealthcare MA Members to Have Access to UPMC

UnitedHealthcare Medicare Advantage members will now have in-network access to care at all UPMC facilities. The new access will shuffle the Medicare market in Western Pennsylvania. While...

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Highmark Decreasing 2016 MA Plan Premiums

Highmark is decreasing premiums for seven of their nine 2016 Medicare Advantage (MA) plans, according to the Pittsburgh Tribune-Review. The move is part of their attempt to hang onto their existing...

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UPMC Settles with U.S. Justice Department for $5.4M

UPMC reached a $5.4 million settlement with the U.S. Justice Department as part of a massive investigation into implantation of cardiac devices against Medicare guidelines. The whistleblower-driven...

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Highmark MA Members Retain Access to UPMC

More than 182,000 seniors in Western Pennsylvania can breathe a sigh of relief. The Pennsylvania Supreme Court has issued a ruling that Highmark Medicare Advantage members will have in-network access...

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State Attorney General Joins FTC in Hospital Merger Opposition

Pennsylvania State Attorney General Kathleen Kane is joining the Federal Trade Commission in a legal block against the proposed merger between Penn State Milton S. Hershey Medical Center and...

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PA MLTSS Contracts Awarded to AmeriHealth Caritas, Centene, & UPMC

Pennsylvania’s Department of Human Services has granted AmeriHealth Caritas, Centene Corp., and UPMC contracts for its new Medicaid program. Community HealthChoices, Pennsylvania’s first-ever program...

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PA Changes LTC Partnership Requirements

Pennsylvania Insurance Commissioner Teresa Miller recently announced a change in Long-Term Care (LTC) Partnership requirements that should help hold down premium increases. The adjustment allows for...

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Highmark Will Stay in ACA Marketplace

Highmark recently announced it has no plans to leave the ACA Marketplace. Unlike other carriers who have dropped out or scaled back coverage for 2017, Highmark plans on sticking with the exchange in...

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