Pennsylvania Attorney General Josh Shapiro Files Lawsuit Against UPMC

By February 7, 2019 One Comment
Bethany Ruhe
Pittsburgh Current Associate Publisher

The Pennsylvania Attorney General’s office filed legal action today against UPMC, claiming the non-profit healthcare provider has been less than charitable in exchange for its tax exempt status.. This follows on State Senator Jay Costa’s (Democrat, Forest Hills) proposed legislation to compel UPMC and fellow local insurance giant Highmark to play nice.

“Our petition today has a simple goal: to restore fairness to the healthcare system in western Pennsylvania and promote the public interest by ensuring patient access to affordable care and facilities which they have funded through their tax dollars,” AG Josh Shapiro said in a statement. “As the Chief Law Enforcement officer for the Commonwealth of Pennsylvania, it is my constitutional mandate to ensure that charitable organizations like UPMC comply with our laws governing their conduct.  We have concluded that UPMC is not fulfilling its obligation as a public charity.”

According to the AG’s office, the goals of the lawsuit are to:

  • Enable open and affordable access to UPMC’s health care services and products through negotiated contracts with any health plan;
  • Require last, best-offer arbitration – commonly known as “baseball arbitration” – when contract negotiations between insurers and providers fail; and
  • Protect against UPMC’s unjust enrichment by prohibiting excessive and unreasonable billing practices inconsistent with its status as a non-profit charity providing healthcare to the public.

If this all sounds like an issue you’ve heard a lot about lately, you can credit Allegheny County Controller Chelsa Wagner, who has made insurance reform a priority of her office. She announced her HealthCarePGH initiative at her reelection launch party on Jan. 16th, and it has been picking up support ever since.

Wagner told the Current Thursday night that she has “been pushing every lever that I could on this for many years. Attorney General Shapiro is a former colleague and [this was] was among the conversations that I had with him. I told him that was my number one priority, and because of the unique powers of that office to intervene, I’m very very pleased that he has taken this issue on. I know there were others who have been advocating alongside with me on this issue, which impacts to many of us.”  Wagner was on her way to a townhall meeting to hear from constituents about the UPMC/Highmark split. There will be three additional meetings in the next 10 days.

Chelsa Wagner addresses a townhall meeting Thursday night regarding the UPMC/Highmark split. (Current Photo by Jake Mysliwczyk)

She visited Pittsburgh Current Podcast January 24th to discuss HealthCarePGH, and penned an op ed describing her personal experience with fractured health care. In the Podcast interview, Wagner said she was hopeful that Shapiro would pick up the fight to keep UPMC and Highmark from splitting. In an official statement Wagner said:

 “The actions announced by Attorney General Shapiro today are major steps toward ending the predatory behavior of UPMC, and I commend him for his political courage in pursuing this matter into the courts. I believe this has occurred in large part thanks to our citizens raising their voices to demand action, and I thank all those who have stepped forward with their stories and concerns The stories we heard in our first Town Hall Meeting and that have been submitted to our website illustrate the stakes we face, which for many patients are nothing short of life or death. But until a final solution is secured ensuring access to the doctors we trust and hospitals we have built with our own tax dollars, we must continue to amplify our message:  We will not accept the intolerable behavior of UPMC as cited by the attorney general and experienced by so many of our residents, and we will not settle for half-measures that fall short of full access to institutions built on our residents’ backs.”

Her full statement is available here.

One Comment

  • Barbara Bardo says:

    Grateful thanks to Chelsa Wagner and Attorney General Shapiro for their actions to help those of us with Highmark insurance who are being hurt by UPMC. I have renewed faith that a solution will be found to ensure access to healthcare for all of us.

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