A federal judge in Alabama has ruled against UPMC in its bid to allow Blue Cross Blue Shield insurance plans nationwide — other than Highmark in Pittsburgh — to contract directly with the Pittsburgh health care giant.
The ruling Tuesday by U.S. District Court Judge R. David Proctor of the Northern District of Alabama rejected UPMC’s request to intervene in a 7-year-old lawsuit against Blue Cross Blue Shield plans by some of the insurance association’s members. The ruling can be appealed.
If the ruling stands, it could restrict patient volume at UPMC’s flagship hospitals in Pittsburgh after June 30 by making it harder for anyone with Blues coverage and living outside Pennsylvania to get treated there. More than 100 million members have coverage through Blue plans nationally.
Meanwhile, in a separate lawsuit, this one in the Pennsylvania Supreme Court, UPMC rival Highmark said it is bracing for the “immediate wrecking ball” of having to pay UPMC list prices after June 30 for its members who receive emergency care at UPMC hospitals — estimating that the cost for these services could increase by hundreds of millions of dollars.