OBGYN Associates of Erie requests to end contract with Highmark

Highmark customers may have to look elsewhere or pay the out-of-network price for OBGYN care and more before the end of the month, after OBGYN Associates of Erie requested to end their contract with Highmark Health.

According to a Highmark spokesperson, OBGYN Associates of Erie recently requested to end their contract with the company, effective May 15, removing the provider from the network of several healthcare plans.

In addition to obstetric and gynecological care, OBGYN Associates of Erie also includes Primary Care Associates and Podiatric Surgical Associates of Erie.

Highmark said the fallout comes after OBGYN Associates asked for “significant” rate increases paid to them for care to Highmark members and would raise costs for the community.

While Highmark said they’re negotiating a limit to cost increases for members, they said OBGYN Associates’ requests to increase how much they’re reimbursed would make it a significant outlier in their in-network providers.

That gap sits at the center of why the two sides have not been able to reach an agreement on a new contract to keep providing care to Highmark members, Highmark said in their statement.

We reached out to OBGYN Associates of Erie for comment and are waiting to hear back.

Highmark Health’s full statement reads as follows:

“OBGYN Associates of Erie (including Primary Care Associates and Podiatric Surgical Associates of Erie) has requested to terminate all of its contracts with Highmark effective May 15. This means our Commercial, Medicare Advantage, ACA, FEP, and CHIP members would no longer be able to access care at OBGYN Associates as an in-network provider.

Additionally, OBGYN Associates has requested significant increases in the rates we pay them to care for our members. This increases costs that are paid for by the community.

We are continuing to negotiate to limit cost increases for our members and customers and to offer fair and reasonable reimbursement rates, however, OBGYN Associates’ request for increases in reimbursement would make it a significant outlier in our provider networks.

Given the gap in rates, we have not been able to reach a sustainable agreement on a new contract that keeps access to care affordable for our members and customers.“

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