PA Supreme Court rules lower court will decide possible UPMC-Highmark consent extension

HARRISBURG, Pa. — The Pennsylvania Supreme Court has ruled Tuesday against extending the consent decree between UPMC and Highmark.

The decree will now expire on June 30th. A spokesperson for the Pennsylvania Attorney Genera's Office said this will stay with a lower court, and a hearing will be held there to decide if an extension will be granted.

>>RELATED: Pennsylvania high court takes UPMC-Highmark insurance case

The two companies signed a five-year consent decree that kept in-network rates for Highmark customers in the Pittsburgh region and Erie.

The end of that agreement may make patients with Highmark insurance unable to get in-network treatment through UPMC's network.

Late Tuesday, UPMC issued a statement following the court's decision:

"This afternoon a four-member majority of the Pennsylvania Supreme Court held that it could not decide the scope of the modification provisions in the Consent Decrees without an evidentiary record and therefore remanded the case to the Commonwealth Court for an expedited hearing. Three justices, in dissent, indicated that they had no problem holding that the modification clause cannot accommodate what the OAG is trying to do. None of the justices, notably, accepted the OAG’s position that the modification clause was unlimited, deciding this issue was a matter for Commonwealth Court to resolve after receiving additional evidence. Importantly, all the justices agreed that it was not necessary for them to extend the termination date of the Consent Decrees through their extraordinary powers."

Attorney General Josh Shapiro also issued a statement Tuesday:

"Today, the Pennsylvania Supreme Court took a crucial step towards delivering justice for the people of Western Pennsylvania by agreeing with my Office's argument and reversing Commonwealth Court's decision that the end date of UPMC/Highmark's consent decrees could not be modified as a matter of law. As directed by the Supreme Court, my Office will now make our case in Commonwealth Court on an expedited basis that modification of the end date is not just permitted—but necessary to ensure UPMC fulfills its role as a public charity and isn't able to shun the very taxpayers whose tax dollars built their business."

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