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Arbitrators side with UPMC; Highmark must pay $188 million for cancer care

By TribLive  
   November 11, 2015

An arbitration panel sided with UPMC over rival Highmark Inc. in a $188 million contract dispute related to cancer care payments, according to documents UPMC filed Tuesday with a municipal regulator. The insurer improperly reduced oncology payments to the hospital system for patients with Highmark's commercial plans from April 2014 through Oct. 2015, the three-person state panel determined Friday. UPMC included the panel's decision in a financial update the hospital system filed with the Municipal Securities Rulemaking Board. While the panel's decision was limited to cancer payments to UPMC Shadyside Hospital, UPMC said in a summary of the arbitration that Highmark has agreed to pay a total of about $188 million to resolve claims across the hospital system.

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