UPMC applauds the ruling, but the Pennsylvania Attorney General's Office says it will file an appeal with the state supreme court.
A state court has rejected the Pennsylvania Attorney General's attempt to modify and extend a five-year consent decree governing University of Pittsburgh Medical Center's dealings with rival Highmark.
Pennsylvania Commonwealth Judge Robert Simpson ruled Wednesday that the AG's office did not have the authority to modify the consent decree—which expires June 30—without the consent of both Highmark, which agreed with the modifications, and UPMC, which did not.
"Because the OAG does not plead fraud, accident or mistake, this court lacks the power or authority to modify the termination date of the consent decree without the consent of the parties, even if it were in the public interest to do so," Simpson wrote in a 45-page ruling.
UPMC Chief Communications Office Paul Wood said in prepared remarks that the health system "agrees with the Commonwealth Court ruling that the Consent Decrees end on June 30, 2019, which is exactly what the Pennsylvania Supreme Court unanimously decided last year."
Simpson declined to rule on UPMC's counterclaims that Pennsylvania Attorney General Josh Shapiro did not have the authority to regulate nonprofit organizations, nor did the judge rule on Shapiro's claim that UPMC was not meeting its charitable obligations.
Shapiro's office filed suit against UPMC in February, asking the court to allow for the modification and extension of the consent decree indefinitely, arguing that UPMC was violating its obligations as a nonprofit organization.
UPMC countersued two weeks later, claiming the AG's office lacks the legal authority to meddle in UPMC's negotiations with Highmark and other health plans.
Related: Pennsylvania AG Accuses UPMC of Ignoring Charity Obligations
Related: How UPMC Turned Innovation Into Enterprise
Related: Unconstitutional Interference? UPMC Countersues Pennsylvania AG
Shapiro's spokesman Joe Grace said the AG will appeal the ruling with the Pennsylvania Supreme Court.
"Judge Simpson ruled that Commonwealth Court itself could not extend the date of the consent decrees—not that such a modification was barred," Grace said. "This enables our office to quickly appeal to the Supreme Court, which we will do in short order given the impending scheduled expiration date."
"As this complex legal process plays out, Attorney General Shapiro will continue fighting for the best interest of patients, payers and the public in Western Pennsylvania and uphold their access to the healthcare facilities they have contributed to building," Grace said.
The UPMC-Highmark feud has been long-running, as the payer-provider organizations have jockeyed for market dominance in western Pennsylvania.
State officials required the two to work together, imposing a consent decree in 2014 that required each health plan to cover services provided by the other organization. That decree is set to expire June 30.
“Because the OAG does not plead fraud, accident or mistake, this court lacks the power or authority to modify the termination date of the consent decree without the consent of the parties, even if it were in the public interest to do so.”
Pennsylvania Commonwealth Judge Robert Simpson
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.
KEY TAKEAWAYS
A state judge says Pennsylvania's attorney general does not have the power to modify the consent decree without the assent of UPMC and Highmark.
Highmark had agreed to the AG's modifications. UPMC had not.
The existing five-year consent decree expires on June 30.