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Pa. Auditor General Threatens UPMC Audit If It Fails To Reach Highmark Deal

PITTSBURGH (KDKA) -- In Pittsburgh Wednesday afternoon, Pa. State Auditor General Eugene DePasquale has a warning to UPMC and Highmark.

"The UPMC-Highmark battle must stop, and it must stop now. The 2014 deadline is fast approaching," said DePasquale.

At the end of next year, UPMC says Highmark insurance customers will no longer be welcome at UPMC facilities and doctors unless they pay the higher out-of-network costs.

Here's the issue.

UPMS says now that Highmark has decided to compete against them for doctors and hospital care, why should they help the competition?

But elected officials like DePasquale say here's why: millions of tax dollars have been pumped into these hospitals and they should remain open for everyone.

"Let me be very clear. There are significant tax investments in these hospitals and health systems," he added.

The auditor general cited Medicaid funding for the poor when they use UPMC, $64 million in taxpayer capital investment at UPMC and Tobacco Settlement funds -- and DePasquale promised an audit of UPMC if they failed to reach an agreement with Highmark.

"I will have no choice but to come in and do a full scale audit to make sure that we find every bit of waste, fraud, and abuse in this system," he said.

DePasquale said he cannot force UPMC and Highmark to cut a deal -- but he expects both to act in the public interest.

"There are no winners when two health care giants go to war," he said. "However, there will be a lot of losers. There have been and will continue to be -- and it's the people of southwestern Pennsylvania."

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