Highmark’s proposed cuts to doc reimbursements kicks off fight

(Harrisburg) — Health insurer Highmark recently announced plans to scale back reimbursements for doctors who see its patients.

Now, the state’s largest advocacy group for doctors is trying to stop the change.

Highmark’s pending four-and-a-half percent reimbursement cut has the Pennsylvania Medical Society on a full-court press.

Its President Dr. Scott Shapiro wrote a letter to the state Insurance Department condemning the move, and the group has issued at least three press releases on the issue in the past couple of weeks.

Shapiro says the change could impact patient care.

“If an insurance company is not balancing their budget appropriately, if they’re paying exorbitant salaries, if they have large reserves, and if ultimately their actions are putting a burden onto practices, I think that’s an issue for the government to get involved in,” he says.

Shapiro says it will be tougher for doctors in private practice to remain viable.

“What it boils down to, is [the proposed rate cut] jeopardizes the ability of doctors and patients to continue to see each other is an issue we felt that the Insurance Commission should get involved in.”

But a spokeswoman with the Insurance Department says it doesn’t have to approve Highmark’s move, which is expected to take effect next month.

The insurer says it needs to cut payments to doctors who see patients with insurance plans purchased on the federal marketplace to stabilize its business.

It adds it’s already used significant reserves to pay for medical care for people on the plans.