Health insurer Highmark talks begin on hospital reimbursement for Medicare Advantage

Health insurer Highmark Inc. and a group of independent community hospitals will sort out how much is owed the hospitals over the next few weeks, following a brief conference Wednesday before Allegheny County Common Pleas Court Senior Judge R. Stanton Wettick.
Lawyers for both sides said they would work out the details of a financial settlement for Wettick’s review in the next few weeks. The amount each hospital is due will depend on the number of Highmark Medicare Advantage patients each facility treated since January 2014.
On May 8, Wettick found that a 2 percent reimbursement cut implemented by Highmark violated the contracts with a dozen community hospitals in Allegheny and five nearby counties. The reduction was prompted by the f ederal government’s 2 percent across the board funding reduction in April 2013, called sequestration, which was designed to shrink federal spending.