A federal judge denied insurer Highmark's request Tuesday to block a Wednesday state court hearing over its health plan for seniors, which state officials say violates a previous agreement between Highmark and healthcare giant UPMC.
Senior U.S. District Judge Maurice Cohill Jr. said stopping the hearing would have violated the Anti-Injunction Act because it would have required a federal judge to interfere in a state court proceeding.
At issue is Highmark's new Community Blue Medicare HMO. The plan, for seniors, does not include UPMC physicians or facilities in its network. That exclusion, Pennsylvania officials say, is contrary to the terms of a consent decree signed by Highmark and the state in July. Highmark disagrees, saying its plan already has been approved by the CMS.
The hearing Wednesday will address the state's assertion that Highmark should be held in contempt for violating the consent decree and stopped from offering the plan. The hearing was set for 1 p.m. ET in the state capital of Harrisburg.
Tuesday's decision is the latest development in the ongoing saga between Highmark and UPMC that peaked when Highmark agreed to acquire West Penn Allegheny Health System, which has been UPMC's main competitor. It renamed the system Allegheny Health Network.
The two systems have since battled over in-network and out-of-network options for Highmark patients and are working through a transition plan approved by the Pennsylvania Insurance Department, which outlined which UPMC facilities and services will be available in-network to Highmark patients.
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