Erie’s largest obstetrics-gynecology clinic has informed its patients that it would cease accepting Highmark health insurance on May 15 unless a new provider deal is struck.
OB/GYN Associates of Erie is an independent medical practice with four locations: two in Erie, one in Titusville, and one in Ashtabula, Ohio. Its doctors deliver infants and undertake gynecological treatments at UPMC Hamot and Saint Vincent Hospital.
In a letter dated Wednesday, OB/GYN Associates advised patients with Highmark insurance to call the insurer and persuade it to reach a new deal.
“We want you to know that our group is doing everything we can to negotiate our agreement with Highmark,” OB/GYN Associates wrote in the letter. “In the meantime, we will do everything possible to provide you with continuity of care and to minimize any disruption which impacts your care.”
A message left with OB/GYN Associates seeking comment was not returned.
Highmark executives said in a statement that they are still negotiating with the clinic. A provider agreement specifies how much a medical office or hospital will earn from health insurance for covered treatments, such as office visits and procedures.
“Like other physician practices across the country, OB/GYN Associates of Erie is facing many challenges in today’s economic climate,” officials noted. “We recognize this and have been negotiating to offer fair and reasonable increases in our reimbursement rates but have not been able to reach an agreement on a new contract.”
If an agreement is not reached, expectant women and those being evaluated for a surgical procedure may still be covered for their delivery or course of treatment, according to OB/GYN Associates. They suggested that the patients contact Highmark to request continuity of care forms.
Erie Medical Practice Has a History of Heated Negotiations
OB/GYN Associates has a history of high-profile negotiations with local hospitals and health insurers.
- In 2011, its physicians transitioned from working largely at Saint Vincent to UPMC Hamot. Dr. Michael Scutella, one of its physicians, was appointed medical director of the then-Hamot Women’s Hospital, which is now UPMC Magee-Women’s in Erie.
- In early 2014, the practice joined with Bayside OB/GYN & Infertility, and its doctors started delivering infants and performing treatments at both Saint Vincent and UPMC Hamot. The transaction occurred at a time when UPMC looked to no longer take Highmark insurance.
Both Hamot and Saint Vincent have OB-GYN practices that are owned by the health system. Saint Vincent’s is AHN North Coast OB/GYN, while Hamot’s is Magee-Women’s Specialty Clinic in Erie.