Hospitals sue Highmark over Medicare Advantage payments


A group of Pennsylvanian hospitals filed a lawsuit against Highmark Monday, reports the Pittsburgh Business Times. The hospitals claim the insurer, along with Keystone Health Plan West, shorted the hospitals two percent of Medicare Advantage reimbursement. Back in October 2013, Highmark alerted the hospitals of the two percent cut, which was due to sequestration. Yet none of the contracts allow for such a reduction without changing the agreement--the hospitals are saying that the reduction is a breach of contract. "The issue here is whether the intermediary, Highmark, can pass along the 2 percent reduction," K&L Gates Partner Edward Weisgerber, who represents the hospitals, told the paper. Article