UPMC, Highmark Reach Agreement on Continuity of Care Provision


Highmark and UPMC have announced that they have reached agreement on the application of the Continuity of Care provision in the Consent Decrees each reached in 2014 with Commonwealth officials. This is effective for the remaining term of the Consent Decrees beginning January 1, 2016 and continuing until June 30, 2019.

“This confirms that decisions regarding continuity of care are to be made by the patient and his or her treating physician, subject to appeal by Highmark to the Pennsylvania Department of Health.  As always, consumers who want to be assured of full and unfettered affordable in-network access to UPMC physicians and hospitals should choose an insurer other than Highmark, including UPMC Health Plan, Aetna, Cigna and United Healthcare.  Consumers choosing to remain with Highmark for 2016 should consult with their physician to determine if they will be covered by this agreement,” said Paul Wood, UPMC’s vice president and chief communications officer.  

To read the agreement, visit UPMC Highmark Continuity of Care Settlement Agreement.