News

As you may have heard, US Digestive Health, a large gastroenterology practice offering specialized GI care with more than 40 locations in PA and DE, has requested to terminate from our networks in PA and DE. The current contract is set to expire on July 1st, 2024.

Highmark has been negotiating to limit cost increases for our members and customers and to offer fair and reasonable reimbursement rates but has not been able to reach an agreement on a new contract. In the event an agreement cannot be reached, here are some things for you and your clients to be aware of.

Which lines of business are impacted by these contract negotiations?

• Pennsylvania: Commercial, ACA, Medicare Advantage, and CHIP.
• Delaware: Commercial, ACA, Medicare Advantage, and Medicaid.
• Highmark Wholecare’s Pennsylvania Medicaid members will not be affected by these negotiations and will continue to have access to US Digestive Health physicians that are currently contracted.

Will Continuity of Care be offered?

• Members in an active course of treatment may continue treatment for a period of up to 90 days after July 1, 2024.
• Members will be directed to call Member Services at the number on the back of their ID card with questions or to request continuity of care.
• Members can find an in-network doctor or hospital by logging into MyHighmark and clicking Get Care to access the provider search.

We will continue to keep you informed as information becomes available.