Case Details

Year Initiated/Committed

2007

Year Resolved

2007

Settlement Amount

$150,000 investigative costs

Court

U.S. District Court for the Western District of Pennsylvania

Lead State

PA

Participating States

PA

Defendant(s)

University of Pittsburgh Medical Center;

Case Description

UPMC sought to acquire Mercy Medical System, another hospital system in Western Pennsylvania. The parties agreed to a consent decree to resolve antitrust issues. Under the degree, UPMC must 1) extend existing health plan contracts and their pricing with Mercy for eight years; 2) negotiate in good faith, contracts for inpatient and outpatient hospital services at UPMC Mercy. 3) Cooperate in the transfer of patients to non-UPMC facilities when those patients have a health plan, which does not have UPMC as a provider and not refer a patient to UPMC facilities when those facilities do not participate in the patient’s health plan.
4) Maintain an open medical staff at UPMC Mercy for all qualified physicians in Western
Pennsylvania. 5( Refrain from entering into any health plan contract that expressly limits a UPMC Health Care Provider’s ability to contract with another health plan.
6) Provide access and equal treatment to UPMC Mercy’s hospital services even if the patient purchases other health-care services from non UPMC providers, is underinsured or
uninsured. 7) Provide a written notice to the Attorney General’s Office before acquiring any hospital in Western Pennsylvania, or permitting any hospital in Western Pennsylvania to acquire a UPMC member hospital. 8) Pay $175,000 in investigation costs.