Highmark Health Reduces Reimbursement Rates By 4.5% For Marketplace Plans

On April 1, 2016, Pennsylvania-based insurer Highmark Health Plan reduced reimbursement rates by 4.5% for services provided to its members enrolled in a Qualified Health Plan (QHP). Reimbursement for Highmark’s commercial plans will remain unchanged. Highmark’s in-network provider contracts prevent provider organizations from refusing to serve new or established consumers enrolled in a Highmark QHP.

QHPs are purchased through the federal Health Insurance Marketplace created by the Patient Protection and Affordable Care Act of 2010 (PPACA). QHPs are intended for people earning between 100% and 400% of the federal poverty level who are not offered . . .