ASC takes on UPMC for exclusion from health plan network: 5 things to know

Laura Dyrda -

Advanced Center for Surgery Chairman Joshua Port took on UPMC during a hearing Wednesday for excluding the center from individuals covered under the UPMC Health Plan's provider network, according to the Altoona Mirror.

Here are five things to know.

1. During the hearing, Mr. Port testified his ASC was excluded from the UPMC network, even though it would accept competitive reimbursement from other providers. The ASC offers advanced surgical techniques, including minimally invasive procedures.

2. Advanced Center for Surgery has a low infection rate, and its facility fee is 40 percent lower than the hospital's, according to the report. Mr. Port testified his center could provide "greater continuity of care" than the group UPMC employs as temporary physicians, replacing physicians who left its practice.

3. Mr. Port told state Auditor General Eugene DePasquale at the hearing that antitrust laws to stop integrated health systems from excluding providers from their networks would improve the state. "Integrated healthcare systems do not favor patients and healthcare providers," he said, according to the Mirror report.

4. During the hearing, Mr. Port referred to integrated health systems as "predatory and monopolistic" and indicated they could increase healthcare costs and damage independent medical providers by excluding them from the health plan network.

5. Advanced Center for Surgery opened in 2012 and provides orthopedics, podiatric services, ENT services and pain management.

 

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