The Pennsylvania Insurance Department may use its authority to delay the end of the contract between Highmark and University of Pittsburgh Medical Center (UPMC) if they can’t settle by June 30, 2012.

The state insurance department can’t force an agreement, but under Act 94 of 1975, it can suspend for up to six months the termination of the contract, now set for June 30, 2012, between Highmark and UPMC, according to Pennsylvania Insurance Commissioner Michael Consedine.

Act 94 was enacted to stabilize the relationship between Blue plans and hospitals, and to see that services remain available to subscribers.

The law has been invoked twice since 1975.

The insurance department would use the six months as a “cooling off” period between the companies while also beginning the process to resolve their issues, according to Consedine.

“During this time we would act as a facilitator and conduct public hearings for the purpose of investigating the reasons for the termination,” Consedine told the state Senate Banking and Insurance Committee at a hearing Sept. 13.

The insurance department could recommend the contract continue or suspend the contract for another 90 days for negotiations between UPMC and Highmark.

With Act 94, termination could be extended until at least the end of April 2013. Then, since the current Highmark-UPMC contracts contain a one-year run-off, a Highmark subscriber will have access to these hospitals through June 30, 2013.

Highmark Medicare Advantage Plan subscribers and Medicaid beneficiaries will not be impacted by a contract termination, according to Consedine. Highmark subscribers who are in a UPMC hospital or treated by a UPMC doctor will continue until the treatment is finished. Hospital contracts with Highmark that end after 2012 include Hamot Medical Center, Children’s Hospital and Mercy Hospital.

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