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UPMC awarded over $188 million in arbitration with Highmark over rates for outpatient oncology services

Jones Day client University of Pittsburgh Medical Center ("UPMC") won over $188 million in arbitration against health insurer Highmark Inc. The breach of contract case concerned Highmark's decision, effective April 1, 2014, to decrease the rates it paid to UPMC's hospitals for outpatient oncology services and drugs. The three-member arbitration panel unanimously held that Highmark breached its contracts with UPMC, including an agreement brokered by Governor Tom Corbett in 2012, and that Highmark's arguments to the contrary were "completely lacking in credibility or evidentiary foundation." The panel, by a 2-1 decision, further held that Highmark breached the covenant of good faith and fair dealing by reducing its payments. Retired federal judge Fern Smith presided over the arbitration and wrote the panel’s decision.

UPMC v. Highmark, Inc., Claim No. 01 14 0002 1500 (AAA)

For additional information about this matter, please contact: Paul M. Pohl, Leon F. DeJulius Jr., Rebekah Byers Kcehowski

Client(s): University of Pittsburgh Medical Center (UPMC)
Office(s): Pittsburgh