HARRISBURG – Western Pennsylvania health care behemoths UPMC and Highmark struck a deal announced Monday that averts the looming breakup of their business relationship and prevents disruption and higher costs for some patients.
The contract will extend Highmark insurance customers’ in-network access to UPMC doctors and hospitals for another decade, access that had been scheduled to expire Sunday with the end of a five-year, state-brokered consent decree.
Attorney General Josh Shapiro, a Democrat who earlier this month lost a court decision in his effort to extend the companies’ relationship, called the agreement a good deal for patients and the public.
“When you’re sick, every day matters,” Shapiro said at a news conference in Pittsburgh. “Today, millions of Pennsylvanians and their families can rest easy because they don’t have to worry about their health care changing after June 30.”
UPMC had opposed renewing their agreement in 2012 after Highmark purchased what is now Allegheny Health Network and became what UPMC viewed as a competitor in providing health services and insurance coverage. Difficult talks that followed eventually produced a five-year consent decree that was set to expire Sunday.
UPMC noted in a statement posted online that the new contract covers all of Western Pennsylvania. UPMC described the agreement as “built on a foundation of trust, compromise and collaboration.”
Highmark Health chief executive David Holmberg called it “a significant step forward for our region.”
“Consumers and patients have two outstanding health systems, in addition to our many independent community hospitals, to choose from for their care,” Holmberg said in a statement. “This announcement brings the certainty of health care access to thousands of people in our community.”
Holmberg said terms and conditions will be finalized in the coming weeks.
Shapiro said “intense dialogue over the past week” with Holmberg and UPMC chief executive Jeffrey Romoff eventually produced the deal.
The attorney general said the two companies agreed “they will no longer act as adversaries but instead work as allies, and we will be better off for it – patients, the region and the commonwealth.”
The fate of Highmark’s insurance customers in Western Pennsylvania looked bleak on June 14, when a Commonwealth Court judge said the consent decree could not be extended through litigation past its expiration date.
Shapiro said his lawsuit will be withdrawn, but his office plans to monitor UPMC and similar organizations for compliance with state law governing charities. Shapiro’s lawsuit, filed in February, claimed UPMC had not been living up to its obligations as a public charity, status that protects it from taxes.
The lawsuit accused UPMC of wasting charitable assets through “exorbitant executive salaries and perquisites in the form of corporate jets and prestigious office space waste.”
A news release Monday from state Rep. Bud Cook, R-West Pike Run Township, noted the state auditor general’s office acknowledged it had received his request to audit Washington County’s Local Share Account grant program of gambling revenues from The Meadows Racetrack & Casino.
But Gary Miller, spokesman for Auditor General Eugene DePasquale, said confirming a formal request is “not an indication we’re going to launch an audit.
“A closer review is under consideration depending on the availability of audit staff. Nothing has been ruled in or ruled out.”
Cook, a member of the House Gaming Oversight Committee, in April began seeking co-sponsors of an overhaul of Washington County’s Local Share Account, which has earmarked $89.7 million to 391 projects since casino gambling money became available in 2008.
After holding public hearings, the committee makes a recommendation to the county commissioners, who forward a list to the state Department of Community and Economic Development for final approval.
The projects have ranged from the modest – an automatically opening door at the Washington Senior Citizens Center – to the massive, such as multimillion-dollar allocations to the Alta Vista and Starpointe business parks to the mixed-used Southpointe II, which includes office, retail and residential areas.
The memorandum seeking co-sponsors for Cook’s legislation, which can be viewed on the state House of Representatives website, leaves intact a formula for which most municipalities of a certain size directly receive casino revenue.
Put in place a few years after the program’s inception, the direct allocation generally gives municipalities $25,000 plus $10 per resident to be used “for any lawful purpose.” The exceptions in Washington County are tiny Green Hills Borough and North Strabane Township, which, as the casino’s host community, has a separate funding stream.
Communities can apply for additional projects, and nongovernment entities that don’t receive an automatic allocation are also eligible to make a case at annual public hearings.
Cook’s memorandum strikes language from the bill that sets up a competitive grant process for projects dealing with economic development, infrastructure, job training, community improvements and “other projects in the public interest.”
According to the memorandum, the change he proposes for gambling revenue distribution is that the state treasury will give money “directly to school districts within the host county which shall be used exclusively for reducing the school district property taxes of homesteads and farmsteads” enrolled under the Taxpayer Relief Act.
The school tax reductions would be based on population and would be in addition to the allocation already reflected on current tax bills.
But in his statement Monday, Cook said, “This is not about taking away LSA grants.” He said he wants to visit “local borough and township leaders that have requested more information about the LSA audit and/or who have concerns with my proposed legislation to address the lack of action to resolve these concerns.”
The legislator, whose district includes parts of Washington and Fayette counties, cited lack of adequate voting records or meeting minutes on LSA committee votes, deliberations or discussions that lead to recommendation or rejection of applicants; ethics statements that would reveal potential conflicts of interest; and the length of time – some dating to 2008 – that committee members have served.
Cook posted a video on his Facebook page on the Local Share news release, and while he did not return a call Monday afternoon to the Observer-Reporter, a member of his staff said he planned to release another video later this week.
Washington County Commission Chairman Larry Maggi questioned if grants announced by state legislators have accompanying minutes, open deliberations and recorded votes.
In March, Cook announced a $4 million Business In Our Sites loan and $6 million loan from the same program regarding the former Wheeling-Pittsburgh Steel plant at Allenport through DCED.
As to ethics statements for LSA committee members, Maggi said that, as an advisory board to the commissioners, “I venture to say everybody there has filed a statement” because members are either public officials or elected officials.
Their longevity on the committee is a result of their being “people who know what’s going on in the county, people who are involved in economic development. They’ve got past experience in that,” Maggi said.
After breaking into his parents’ Greene County home, a Washington Township man was mistaken for an intruder and shot in the arm by his step-father, state police said.
William James Wilson, 34, of 793 Dividing Ridge Road, was taken to Ruby Memorial Hospital in Morgantown, W.Va., after he was shot by his 65-year-old step-father, whose name was not released by state police.
According to the criminal complaint, Wilson had been arguing with his parents earlier that morning. Police said about 3 a.m. Wilson had been combative with his step-father and 63-year-old mother, destroying items in their house, where Wilson also lives.
Wilson allegedly told his parents that he would “take their faces off” before he left the house about 3:30 a.m. When he left, they locked and secured the house through their home security system.
At 8:30 a.m., Wilson returned and began knocking and banging on doors and windows in an attempt to get inside the house, police said.
“That sent off about six different motion alarms, so patrol units were already en route for that,” said Trooper Lucas Borkowski, who’s investigating the case.
When the couple heard someone trying to break into their home, they pushed the security system panic button, which connected them to a representative of the security system, who then contacted police. Police said the couple were in a second-floor bedroom when they heard glass breaking on their second-story balcony. They then heard the balcony door open.
Police said the step-father didn’t know it was his son when he peeked out the bedroom door and saw Wilson “charging” down a hallway at their bedroom. Police said they closed the bedroom door, but Wilson forced it open. That’s when the step-father used a handgun to shoot Wilson in the right arm, police said.
“They were both scared … and feared for their lives,” police said of Wilson’s parents in the criminal complaint.
Police said Wilson fled the house to a neighbor’s residence.
“That’s when they realized it was their son,” Borkowski said.
Wilson was charged with terroristic threats, simple assault, recklessly endangering another person and harassment. Police said he will be arraigned once he’s released from the hospital, where he’s in stable condition.
“He had to have a surgery, so he’ll be there a few days,” Borkowski said.
He said the bullet went through Wilson’s bicep, and police were able to collect the bullet and casing. Wilson’s parents haven’t been charged. Borkowski said Wilson’s step-father does have a valid license to carry a firearm.