Pa. online health insurance marketplace opens

Pennie, Pennsylvania’s official online health insurance marketplace, is now open to all state residents to apply, compare plans, and enroll in high-quality health coverage.  

The annual Open Enrollment Period is an opportunity for Pennsylvanians to take advantage of substantial savings on 2023 coverage created by the American Rescue Plan and extended by the Inflation Reduction Act. 

Nine out of 10 Pennie customers qualify for financial savings and thus are eligible for subsidized monthly premiums on their health insurance. Nearly 40% of Pennie customers pay less than $75 per month. Pennie helps keep costs down amid rising inflation, and Open Enrollment is an opportunity for Pennsylvanians to protect their health and wallets by getting the coverage and care they need. 

“Easy access to affordable quality health coverage for all Pennsylvanians who want it is the bedrock on which Pennie was founded. As we strive to maximize the number of insured Pennsylvanians, the goal isn’t just to have insurance but to have insurance someone can actually use,” Pennie Executive Director Zachary W. Sherman said in a statement. “For anyone not insured through their job, Medical Assistance, or Medicare, I encourage them to explore their options through Pennie to see how we can help lower monthly premiums on high-quality health coverage from the top insurance companies across the commonwealth.” 

Representatives from Pennie, the Pennsylvania Insurance Department (PID), and Pennsylvania Association of Community Health Centers (PACHC) celebrated the start of the Open Enrollment period recently at Sadler Health Center in Carlisle.  

Pennsylvania Acting Insurance Company Commissioner Michael Humphreys said the Open Enrollment period marks the premier time to explore options and shop to find a plan, even for those who have insurance. He added that quality, comprehensive health care coverage has never been more affordable or more within reach for Pennsylvanians. 

“The Insurance Department’s goal of increased competition in the Marketplace has resulted in more choices, and increased affordability for consumers across the commonwealth,” said Humphreys. “We encourage consumers to research and compare plans to find coverage that best fits their needs and provides robust benefits for themselves and their families.” 

A recent change in federal policy has improved the affordability of health insurance for family members with insurance through a spouse or parent’s work. In 2023, Pennsylvanians paying more than 9.2% of their household income for a family plan through a family member’s job apply through Pennie to receive premium savings to reduce their cost of coverage. Families previously locked out of receiving Affordable Care Act subsidies can apply or update their application to enroll and receive the savings. 

“Our network of Community Health Centers continues to play a key role in ensuring Pennsylvanians gain the security of health coverage and access to quality affordable care.  In-person, unbiased Certified Enrollment Assisters are available to help patients and customers wade through the complexity of applying for health insurance at many locations statewide,” said Tia Whitaker, Statewide Director of Outreach and Enrollment at the Pennsylvania Association of Community Health Centers. 

As the Inflation Reduction Act has helped to provide additional savings and lower costs of premiums making it easier to enroll in coverage, Whitaker advised those interested to find a local Community Health Center by visiting pachc.org. 

Pennie and PID encourage those seeking coverage to go to Pennie.com prior to Jan. 15 and enroll in one of the options available in their area. Pennie’s Open Enrollment Period extends to Jan. 15, 2023. The deadline for coverage starting Jan. 1 is Dec. 15. For those enrolling between Dec. 15-Jan. 16, coverage will start Feb. 1, 2023. 

Pennsylvania expecting ACA insurance prices to increase

Acting Pennsylvania Insurance Commissioner Michael Humphreys on Monday released the 2023 requested rate filings for insurance plans under the Affordable Care Act.  

As filed, 2023 will see increased competition and more choices for consumers within some counties. Both the individual and small group rate requests will result in a moderate statewide average increase. 

“As we navigate through the aftermath of the COVID-19 pandemic, Pennsylvania continues to have a strong and competitive insurance market,” said Humphreys. “Increased choices and plan options will provide Pennsylvanians with the opportunity to shop for the best coverage options for themselves and their families.” 

Insurers offering plans in the individual market filed plans requesting an average statewide increase of 7.1 percent. Insurers that currently sell in Pennsylvania’s small group market filed plans requesting an average statewide increase of 5.2 percent. 

Insurers are attributing the proposed increases to multiple factors including higher health care costs, projected claims because of deferred care during the pandemic and the end of the American rescue Plan Act subsidies. 

According to the findings, none of the state’s 67 counties will lose an on-exchange insurer. And Ambetter, from PA Health & Wellness, will enter the Berks County individual market for Plan Year 2023.  

Within the small group market, five counties gained a new insurer. Cigna + Oscar will enter the small group market in Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.  

The federal American Rescue Plan’s financial assistance saw out-of-pocket premium costs borne by Pennsylvanians decrease by an average of 9%. Many families who believed that comprehensive health care coverage was beyond their reach were able to purchase plans that provided quality care as a direct result of the ARPA subsidies.  

However, if these subsidies are allowed to expire, Pennsylvanians will see out-of-pocket costs increases, Humphreys said. 


A Conversation With: Anne Baum, Lehigh Valley market president, Capital Blue Cross

LVB: Health care insurers had to adapt quickly to changes brought about by the COVID-19 pandemic. What changes have become permanent? 

Baum: I am incredibly proud of the resilience of our amazing employees at Capital Blue Cross. They were able to quickly adapt and pivot to work at home and didn’t skip a beat, serving our members just as well as they did in the office. We had to learn how to work together virtually, and because we were able to do so, working virtually is now going to be a staple of our business going forward. Our ability to collaborate at any time, from anywhere, has made us a better company. 

LVB: Your company and other health insurers have begun opening “wellness centers.” What is their purpose and do they mark a change in the way insurers are thinking about providing care? 

Baum: For many years, the only connection that most people had to their insurance company was their ID card, or a voice over the phone if they needed help or service. Our Capital Blue Cross Connect health and wellness centers change that dynamic by creating a place where members and prospective members meet face to face with us. Our goal was to provide personal, in-person service to help people better understand their coverage and access to healthcare. 

Not only have we been able to deliver health insurance information to both our members and the general public, but we’ve expanded to include wellness services, health coaching, fitness, and more. Because of this success, we have continued to open new locations throughout our service area. Our newest center is at our newly renovated Lehigh Valley Headquarters on Hamilton Street in Allentown. 

LVB: What are some of the other trends in health care insurance right now? 

Baum: As employers emerge from the pandemic and face the challenge of finding and keeping employees, we are seeing many of them use health insurance and other ancillary benefits – dental, vision, life, accidental death and dismemberment, and short-term disability – as a recruitment tool. Many employers are offering open enrollment electronically. And our team has worked to provide resources to meet these needs. 

The pandemic has rapidly increased demand for mental wellness services, and the use of our Capital Blue Cross Virtual Care platform for access to much-needed behavioral health providers has increased dramatically. 

Employers are also trying to determine how best to navigate the vaccine-mandate issue for their workforce, and our team provides them with reporting and data to help them make decisions about the safe return to the workplace. 

LVB: What changes do you see in the industry down the road? 

Baum: At Capital Blue Cross, we are focused on delivering the best possible member experience, and that means providing members with the information and systems necessary to help them easily access healthcare services. It also means that we are committed to offering a broad range of products and services to meet our customers’ varied needs. As employers work to stabilize their workforce and face competition for hiring, health benefits will continue to play an important role. We are committed to supporting their efforts to deliver excellence to their employees. Insurers, including Capital Blue Cross, also are building closer relationships with provider and health systems in order to deliver the highest quality and easiest access to care. 

Capital Blue Cross set to unveil ‘Connect’ as part of major office renovation

Michael Crnovic, Roseann Humphrey and Anne Baum show the photos and maps that pay tribute to Allentown’s parks system in the new Capital Blue Cross Connect office. PHOTO/STACY WESCOE –

Capital Blue Cross plans to host a grand opening soon at its new retail wellness center, Capital Blue Cross Connect, in downtown Allentown.

The center is part of a $4 million renovation of the three-story building that serves as Capital’s Lehigh Valley headquarters. Anne Baum, Capital’s president for the Lehigh Valley region, said the building was aging and in need of renovation.

At first, she said, they considered moving to a new location, but with all the redevelopment going on in the city, and the office’s location at 1221 Hamilton St., the Western gateway to the downtown, they decided to stay put and remodel what they had.

“We couldn’t find a better location to meet the needs of our company,” Baum said.

Michael Crnovic, director of retail services for Capital, said there was a walk-in customer service area in the building where people could pay their bills and receive some limited services, but despite the foot traffic it was eventually closed.

“It was kind of a makeshift space,” he said. “We closed it, but we wanted that presence back.”

Roseann Humphrey, manager of the Allentown location, said there was a demand for a full-service center where people could come in off the street, talk about their insurance coverage and get health advice.

“There’s a lot to be said about that face-to-face service,” Humphrey said. “You’d be surprised by how many people want that face-to-face communication.”

Customers will be able to purchase or review their health insurance policies with an agent in the office, and get wellness advice, including consultations with a dietician, biometric screening and a finger stick blood test to check for such things as diabetes or high cholesterol.

They will also offer a service to small businesses looking for coverage for less than 50 employees. By using the services available in the new office, small business owners can encourage their employees to work on their health.

In addition, there is a conference room Capital Blue Cross will share with area nonprofits, and a meeting room where the company will offer health education seminars.

The décor of the office is a tribute to the city’s park system. The offices and hallways are filled with photographs of the city’s parks as well as information on where to find them and the activities they offer to encourage visitors to go outdoors and exercise.

Encouraging wellness is an important part of the company’s strategy to improve the health of its customers. Healty customers need less health care and that lowers the cost of care, Crnovic said.

“It’s a critical component for our company to connect with the community,” Baum said.

She also noted that while it has many unique features, it isn’t Captial’s only retail presence in the Lehigh Valley. It opened its first such center in the Promenade Shops at Saucon Valley years ago and has opened similar locations around the state since then.

State College contractor pleads no contest to wage theft, ordered to pay $20 million in restitution 

A State College-based contractor embroiled in one of the largest prevailing wage criminal cases on record, plead no contest to theft and will be paying over $20 million in stolen wages to over a thousand Pennsylvania workers.

Attorney General Josh Shapiro announced that Glenn O. Hawbaker, Inc., one of the largest contractors to complete projects for the state, plead to four felony counts of stealing wages from workers.

From 2003 through 2018, Hawbaker received an estimated $1.7 billion in contracts from the state, Shapiro’s office wrote in a press release.

The contractor admitted in the plea that during those years it took money intended for prevailing wage workers’ retirement funds to contribute to retirement accounts for all Hawbaker employees.

Hawbaker was also charged with stealing funds intended for prevailing wage workers’ health and welfare benefits, using those funds to subsidize the cost of its self-funded health insurance plan for all employees.

The charges were announced in April and came after a three-year investigation into the company’s practices. Investigators said the company disguised the theft for decades by inflating its benefit spending records.

In a written statement to the Central Penn Business Journal, Hawbaker said that it believes it followed all requirements regarding fringe benefits and that the practices challenged by the Office of Attorney General were based on advice provided by the company’s former attorneys.

“Hawbaker has always intended to properly pay all of its employees. Through the years, both state and federal regulators extensively reviewed our Prevailing Wage Act and Davis Bacon Act practices on jobs and did not find any wrongdoing,” the company wrote. “This led us to believe we were properly following all laws, and we did not plead guilty. We fully cooperated in this process and proactively addressed concerns raised by the attorney general’s office. As stated by the attorney general, we are making past and present employees whole.

Hawbaker pleaded no contest to four felony counts of Theft by Failure to Make Required Disposition of Funds Received. The company was sentenced to five years’ probation and the payment of more than $20 million in restitution to 1,267 affected workers.

As a condition of its probation, Hawbaker will pay for a corporate monitor to oversee its compliance with all state and federal prevailing wage laws and regulations.

“A month ago I met with some of the men and women who had their wages and retirements stolen by Hawbaker — and I told them that we will do everything we can to get them every cent they are owed under the law,” said Shapiro when he announced the plea. “A few minutes ago, I was able to tell them that we made good on that promise.

“We took on one of the largest construction companies in the state, and now 1,267 people will have a better shot at retirement; they will get the paychecks they earned under the law; and they will have their work and their livelihoods protected and respected, instead of ignored.”

Shapiro added that his office has heard from other contractors in the state that this enforcement helps their business by deterring other employers from engaging in similar schemes.

Health insurance company to pay restitution to Pennsylvania customers

Pennsylvania’s Insurance Commissioner Jessica Altman said the state has managed to acquire nearly $80,000 in restitution for residents who were customers of Aliera HealthCare.

The state also obtained a $20,000 civil penalty stemming from an investigation into the company’s improper insurance practices.

The Pennsylvania Insurance Department initiated an investigation into Aliera HealthCare in 2019 following complaints from consumers who had unpaid medical bills despite having “coverage” through Aliera. Consumers also alleged Aliera engaged in misleading and deceptive business practices.

Aliera offered what is known as health care sharing ministries, which are not insurance products, but instead are voluntary arrangements in which members who share a common set of religious beliefs share the financial cost of medical bills with other members of that religious community.

The state’s investigation determined that Aliera does not meet the requirements established in The Insurance Department Act of 1921, which lists the criteria for religious sharing ministries and publications and that Aliera violated the state’s insurance laws.

Aliera has entered into a Consent Order with the department, agreeing to cease and desist from engaging in activities related to health care sharing ministries and to pay restitution totaling $79,785.49 to the 95 Pennsylvania members where administrative fees were improperly collected. It must also pay  a $20,000 civil penalty.

“Shopping for health insurance can be stressful enough, without having to worry about whether the company you are purchasing coverage with is deceptively selling a product that is not insurance,” said Altman. “Legitimate Pennsylvania insurance companies have strict standards and regulations that they must follow. The department will not stand for misleading and deceiving consumers, and we are committed to rooting out entities in the insurance industry that flout our rules.”

Aliera HealthCare stopped offering its health care sharing ministry memberships in the state in December 2019.

Capital BlueCross plans health and wellness center in downtown Allentown

An artist’s rendering of the renovated offices. SUBMITTED


Capital BlueCross plans to open a health and wellness center at its offices in downtown Allentown as part of a renovation and expansion project.

The Harrisburg-based health insurer said work has begun on its Lehigh Valley offices at 1221 Hamilton St. and plans to have the project done by February. The expansion effort on the three-story building will include a new façade and a full interior remodeling in addition to the new health and wellness center.

Ann Baum, market president Capital BlueCross said the renovations will make the building fit into the redevelopment efforts going on in the downtown area.

“This is part of a renaissance in downtown Allentown,” Baum said. “We wanted to lend our hand to the redevelopment of the largest city in the Lehigh Valley. We’re committed to the health and well-being of the people and communities here, so this makeover is not just to provide a great space for our employees – it’s to provide a great space for the people of Allentown.”

Once the new health and wellness center is complete members and the public can visit for one-on-one consultations related to health plans or Medicare options.

The can also meet with a health coach, get biometric screenings and attend health care-related seminars.

This will be the health insurer’s second health and wellness center in the Lehigh Valley. It has a similar center in the Promenade Shops at Saucon Valley.

It also has health and wellness centers in Cumberland and Franklin counties.

Grand View Health to accept Humana Inc. insurance

Grand View Health signed an agreement with health insurer, Humana Inc., that will provide in-network coverage for Humana Medicare Advantage members at Grand View Hospital and its outpatient locations.

The agreement means Grand View Health care will be in-network for members of Humana Medicare Advantage Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Private Fee-for Service (PFFS) health plans.

The agreement also will offer in-network access to Grand View Health primary care providers and specialists.

Terms of the agreement, which goes into effect Nov. 1, were not disclosed.

Grand View Hospital is a private, nonprofit facility in Sellersville with 167 beds. Grand View Health has specialized urgent care and outpatient health centers in Bucks and Montgomery counties.

A Conversation With: Glenn Heisey, senior vice president of strategy and business operations at Capital BlueCross

Heisey –


LVB: Health insurers have been making drastic changes in the way they see health care in recent years. What do you see as the top trends?

Heisey: Capital BlueCross continues to make strategic investments in technology that are making it easier for people to choose coverage, monitor the use of that coverage, and make smart decisions about their overall healthcare. Our members can use a laptop or phone to securely access all of their personal health information, schedule virtual medical visits for physical or mental health issues, or get tips on how to stay healthy. Technology makes that kind of convenience possible.

Emerging technologies are also reshaping how we manage population health, giving us the data and analytics to identify healthcare issues that might be costly to an employer, so we can work with that employer and their employees to improve health and save them money. Technology also is empowering us to take a more holistic look at healthcare and examine how things like physical health, mental wellness, prescription drug use and other factors all intersect, so we can help people live their healthiest.

As an example, we offer an analytics platform through  one of our subsidiaries. It offers an array of tools to identify healthcare trends and issues and proactively identify populations that could be at risk for health problems, or benefit from intervention or guidance in maintaining health.

LVB: How does offering wellness, exercise and healthy eating programs to your customers benefit an insurance company’s bottom line?

Heisey: A quality wellness program promotes and rewards healthy behavior, which in turn reduces or eliminates medical issues and related costs for the individual. By helping a member stay healthy, we’re helping to ensure the best possible member experience. That member knows we care about their well-being.

Another benefit of a quality wellness program is for employers, who can use these programs to reward healthy behavior by their employees and help reduce absenteeism, work-related injuries, and long-term health issues that could impact productivity.

Capital BlueCross’ wellness program, Healthy Blue Rewards, gives members useful tools and resources to take charge of their health, guiding them to make meaningful progress toward specific health and wellness goals that they help identify.

LVB: Recently, many insurers started covering telehealth appointments because of the COVID-19 pandemic. How is that going?

Heisey: Capital BlueCross has offered telehealth coverage for several years—long before the pandemic—and we worked with local network providers to improve access to telehealth during the pandemic, including further expanding the types of telehealth providers and services we cover during this time.

We also made the decision to waive member costs for telehealth visits during the height of the pandemic. That waiver was one of several proactive steps we took to encourage members to use technology to safely access healthcare and to help minimize in-person medical visits at a time when doctors’ offices and medical facilities were being strained.

We’ve also waived member costs for medical and behavioral health visits on our own telehealth platform, Capital BlueCross Virtual Care. We saw a sharp increase in Virtual Care medical visits in mid-March and then a gradual decline back to pre-pandemic levels; while, we continue to see a steady increase in Virtual Care behavioral visits. We already knew telehealth was an emerging tool, but the COVID-19 pandemic proves it’s here to stay.

LVB: What do you think the next trends will be in health care coverage?

Heisey: The healthcare landscape in Pennsylvania will continue to be shaped by the increasing number of Baby Boomers reaching Medicare eligibility age. This age group is embracing technology and e-commerce at an increasingly fast pace, opening up new opportunities to communicate with them.

Health insurance industry expert: “The business model is broken.”

Our health insurance industry is in need of repair, according to experts, but there are things employers can do to help.


“The business model is broken,” said Laura Vela, senior director of the Pacific Business Group on Health, a not-for-profit organization that advocates for employers who are purchasing health care plans. Vela spoke at a Feb. 3 health care symposium at Lehigh University, organized by the Lehigh Valley Business Coalition on Health Care, an organization that advocates on behalf of employers regarding health care choices.

Vela advised employers in attendance to question health care networks extensively before purchasing a health care plan for their employees.

“And if they won’t answer your questions,” Vela said, “find a different company that will. We as purchasers of health care have a responsibility to make change.”

To Vela, pharmacy benefit managers, better known as PBMs, are an area where costs can be cut if the right questions are asked.  PBMs are third party administrators for prescription health plans. PBMs act as intermediaries between drug manufacturers and employee benefit plans.

According to Vela, PBM’s can make money in “56 different ways from one prescription.”

“We as health plan purchasers need to find another way,” she said.

Also at the symposium, Dr. Stephen Parodi, executive vice president of external affairs for the San Francisco-based Permanente Federation, a managed care consortium, advised employers to analyze the data on their health care plans before making a future health care plan choice.

Parodi said that health care is slowly evolving from a pay for service model, where health care services are paid for on a per-service basis to value-based care, where payments cover bundled overall care.

For example, in the old model, for a knee replacement, the patient would be charged individually for the before care, the surgery, the follow up visits and the physical therapy. With value-based care, the patient would pay one lower fee that covered all of those services.

“It’s the best of times and it’s the worst of times,” he said. “People are talking about value-based care, but nobody knows what it means…If you don’t know where you are at, there is no way to improve.”

Thinking about health insurance beyond the coverage

On every employer’s wish list is affordable, reliable health insurance. The challenge is finding effective solutions as prices increase, without passing costs on to employees in the form of high deductibles. This may lead to a deficiency of health care for employees who cannot afford it and opt to forego care intervention. Ultimately, employee health problems affect work performance and contribute to higher costs.

Ideally, company leaders will need to think outside the box in order to find realistic solutions to impact employee health, high deductibles and premiums, and their bottom line. Addressing lifestyle risks and all aspects of employee well-being is key. Once employers make the shift in perception, emphasizing preventive care, lifestyle modifications, and the importance of behavioral health, it becomes evident that they can have a big influence on the health of their employees, and therefore, their own expenses. There are resources that employers can provide to educate and support employees with leading healthier lifestyles. Initiating one, or all three of the following, can be a first step toward a comprehensive plan to cultivate a healthier workforce.

Importance of primary care

When the right kind of health care is provided at the right place and time, health care is appropriately utilized across a population, and unnecessary treatments, medications and procedures are prevented. Take, for example, an employee who is diagnosed with high blood pressure. When he or she is treated early and appropriately, more serious chronic health conditions can be mitigated, such as heart disease and stroke. Certainly, high blood pressure is less costly to treat than chronic heart disease. Consider the long-term effects on health care quality and costs across your employee population when care is delivered the right way.

Research shows that health care outcomes and costs are greatly impacted by patient access and relationship with a primary care physician (PCP). An increase of one primary care doctor per 10,000 people has been shown to result in: a 5 percent decrease in outpatient visits, 5.5 percent decrease in inpatient admissions, 10.9 percent decrease in ER visits, and 7.2 percent decrease in surgeries. Furthermore, now that insurance companies are basing reimbursement on outcomes rather than volume of services performed, the PCP’s adherence to quality and accountability becomes a factor that can impact health care costs.

Raising health consciousness

Building morale is closely connected to employee wellness and to curbing expenses. When you have a workforce that is healthy and satisfied, employees care more about the job they’re doing and are more productive. Data shows that employees with health conditions and at high risk for health problems had productivity costs ranging from $15 to $1,601 more per year than similar employees without health conditions/risks. This means that an employer with 10,000 employees could face nearly $3.8 million in productivity loss each year, in addition to medical costs for these conditions.

In this vein, there are many options employers can implement to bring about a shift toward a healthier company culture. There are wellness programs, employee assistance programs (EAPs), fitness programs, and occupational health and safety options available to employers, including those in the Lehigh Valley. It’s important to also consider the supplemental elements: supporting work/life balance, offering healthy options in vending machines, or introducing health challenges and online wellness tools. As the consciousness of the workplace changes and employees get onboard, they feel more empowered, feel better about coming to work and are naturally more productive. Here’s what the Harvard Business Review reports:

“In studies by the Queens School of Business and by the Gallup Organization, disengaged workers had 37 percent higher absenteeism, 49 percent more accidents, and 60 percent more errors and defects. In organizations with low employee engagement scores, they experienced 18 percent lower productivity, 16 percent lower profitability, 37 percent lower job growth, and 65 percent lower share price over time. Importantly, businesses with highly engaged employees enjoyed 100 percent more job applications.”

Variety can add spice to life

Employers can make a difference in the area of insurance benefits as well. Each employee’s health needs are different, as are the ways in which they utilize their employer-sponsored health plan. For those reasons, some employers are offering more than one plan to their workforce. In fact, according to the Employer Health Benefits 2017 Annual Survey, 58 percent of covered workers are employed in a firm that offers multiple health-plan options.

While multiple plans may require some organization, variety allows employees to decide for themselves what coverage is right for them. It can also save employers money, if they opt for one selection as a lower-cost base plan with reduced premiums. Giving employees control over how their health benefits are structured can increase feelings of autonomy and satisfaction, also adding to their overall well-being. This flexibility, combined with a focus on health and PCP involvement, achieves an employer’s number one important business goal: To protect the most valuable asset they have – their employees.

Laura Mertz is associate executive director of Valley Preferred, the physician-led preferred provider organization aligned with Lehigh Valley Health Network. She also oversees the marketing, business development, and provider and payer services functions for Populytics Inc.

UPMC to cut ties with Highmark after court ruling

Pennsylvania Commonwealth Court ruled on Friday that Pittsburgh-based UPMC can stop accepting Highmark Health-insured patients by the end of the month.

The ruling is part of an ongoing argument over the end date of a consent decree between the Office of the Attorney General, UPMC and Highmark Health.

Attorney General Josh Shapiro took UPMC to court this week in the hopes of extending the terms of a 2014 consent decree. The decree gave the systems a five-year transitionary period leading up to June 30, 2019 at which point UPMC would stop accepting patients insured by Highmark.

The state’s Commonwealth Court sided with UPMC, meaning that the health system can finish its transition away from its former partnership with Highmark and its providers will stop accepting the insurer on June 30.

Shapiro said that the split would harm the many Pennsylvanians insured through Highmark that rely on UPMC for their health care.

“Make no mistake, our work here is not done,” Shapiro said in a statement Friday. “While we are disappointed in Judge Simpson’s ruling, I won’t quit on the people of Western Pennsylvania and we will continue to take steps to restore fairness to the healthcare system and give people access to the institutions their tax dollars built.”

Shapiro and his office argued that a provision in the decree allowed for changes in the contract that could be used to rewrite the end date to continue indefinitely.

Commonwealth Court had ruled in April that the consent decree could expire as scheduled on June 30. The Office of the Attorney General appealed the court’s decision, arguing that the decree should be extended because of the modification provision.

Late last month the appeal was heard by the Pennsylvania Supreme Court, which ruled 4-3 in favor of Shapiro, allowing the case to be heard once again in Commonwealth Court. In the Supreme Court’s majority opinion of the case, Justice David Wecht wrote that the Attorney General had the right to have the case heard again in Commonwealth Court, utilizing the modification provision as evidence.

“Given the unbounded language of the Modification Provision, seasoned counsel likely foresaw, or should have foreseen, the possibility that significant alterations might be requested,” Wecht wrote.

Judge Robert Simpson of state Commonwealth Court did not agree with the Supreme Court’s decision and instead claimed that given UPMC’s consistent attempts to try to end its partnership with Highmark, there was no reason to believe that UPMC would have agreed to something that could have made the relationship indefinite.

“The general provision does not include any express limitation; nevertheless, there is no believable evidence that any party intended the general modification provision to override the specific termination/expiration provision which had been the subject of negotiations almost from the beginning,” Simpson wrote.

UPMC released its own statement regarding the ruling, noting that the system was pleased with the court’s decision.

“UPMC is grateful the Commonwealth Court expeditiously reached this decision. We look forward to continuing to fulfill our long-standing charitable mission and serving the public with UPMC’s world-class physicians and facilities,” the system wrote.

Shapiro could still appeal the court’s ruling in the Pennsylvania Supreme Court and said in his statement that his office will be announcing subsequent legal steps next week.