Open Enrollment Period for Health Insurance

In June, a consent decree was brokered by the state between the region’s largest insurer, Highmark, and largest provider, University of Pittsburgh Medical Center (UPMC).  This was essential after the two businesses made it clear that their relationship would go separate ways and UPMC would not renew its contract with Highmark, at the end of this year, following Highmark’s 2011 purchase of West Allegheny Health System.  Up until this agreement, residents with Highmark coverage were faced with possibly having to pay higher, out-of-network fees to use UPMC doctors and hospitals, leaving individuals and families with more uncertainty and instability.  

The five-year deal reached is designed to soften the impact by allowing at risk patients, like seniors, the opportunity to continue to see their UPMC doctors until their conditions were stable or resolved.  In particular, Highmark members who are undergoing treatment for such conditions like cancer will continue to receive that care on a lower-cost in-network basis “for as long as the patient and his/her doctors deem it necessary.”  There will also be a one year “safety net” for Highmark subscribers who are unable to find alternate medical care in their areas.  

The consent decree, which bars revisions or a new contract, will remain in effect for five years.  If a conflict should ever arise between the two businesses over the enforcement of the agreement, an arbitration process will settle it. 

The start of October began the yearly three-month open enrollment period for Highmark’s upcoming 2015 insurance plans.  Highmark has emphasized that the new plans offer employers and consumers more choices for access and cost by offering different coverage levels, or tiers, to their menu of plans. 

Specifically, those patient protections include continued in-network access for emergency care for Highmark members at all UPMC facilities. Additionally, Highmark members will continue to have in-network access to more than 80 percent of UPMC-owned physicians when they are performing services at UPMC hospitals outside the five-county Pittsburgh region or at numerous community hospitals in the greater Pittsburgh service area (Allegheny, Beaver, Butler, Washington and Westmoreland counties). 

For those who need information on which providers will be in-network under the consent decree, you may search http://www.yournetwork2015.com.

As we approach the end of 2014 and the agreement between UPMC and Highmark comes to an end, many people have asked what the Legislature has done to resolve this issue.  Believing every individual should have access to the best health care available to them, the Pittsburgh area delegation came up with House Bill 1621 (HB 1621) and House Bill 1622 (HB 1622), and companion bills, Senate Bill 1247 (SB 1247) and Senate Bill 1248 (SB 1248), that would grant the Pennsylvania Insurance Department the ability to step into a contract termination and expiration dispute if the dispute involves a health system and any health insurer. Furthermore, if there is failure to reach an agreement and this failure would disrupt access to medical care in a region, the Insurance Commissioner would have the power to force the parties into mediation and possible binding arbitration.

Hearings were held on these bills, but no committee action was ever granted.   Unfortunately, our region’s health insurance and hospital provider issue fell victim to the majority party’s unwillingness to come to the table with our delegation and work on a resolution that puts patients’ needs first.  Instead, early inaction by the current administration and majority party in the General Assembly have allowed these organizations to determine what access and providers will be available to patients and at what cost they will be available. 
It’s also important to point out that the proposed bills came during a time when accusations came to light that one of the organizations had created an environment that pays unfair wages and work conditions.  Earlier this summer, there were numerous tales by staff of targeted layoffs and reduced pay or hours among technicians, clinicians and secretarial staff.  Employees also expressed they would not comment on the situation in fear of losing their own jobs or severance.  Many of these employees are barely able to make ends meet to support their families to begin with. 

To end on a personal note, I want you to know that not only have I taken this situation extremely serious because of how it affects my constituents, but also as a consumer caught up in this situation.  Though I have seen a number of highly qualified UPMC doctors for many years for my health care needs, my insurance coverage is through Highmark and I am in the process of preparing to change my personal physicians to those within the system of my Highmark insurance.  I do empathize with the thousands affected by this matter and wish everyone good health and comfort as you continue to weigh your decision.

Absentee Ballots

Any voter who needs an absentee ballot for the November 4th Election must complete and return the application to the Allegheny County Elections Division no later than 5 p.m. on October 28th.  The Elections Division is located in the County Office Building:

542 Forbes Avenue
Room 604
Pittsburgh, PA  15219

Absentee ballot applications can be obtained by clicking here and downloading one, visiting any of my district offices, or requesting one in person at the County Elections Division office at the above mentioned location.

Anyone voting by absentee ballot will be required to provide a PA Driver’s License number, PennDOT ID number, or last four digits of Social Security Number.  If the requester does not possess any of the aforementioned items, a copy of an acceptable ID must be provided with the application.  After submitting the application, an absentee ballot will be mailed directly to the applicant.  The completed absentee ballot must be returned to the Elections Division no later than 5 p.m. on October 31st.  For fastest results, anyone requesting an absentee ballot can apply in person. If properly registered, the applicant will be handed an absentee ballot to vote on the spot.  For more information on requesting an absentee ballot, please call the Elections Division at 412-350-4520.

Fire Company/Volunteer Ambulance Grants

I want to remind all fire and ambulance companies that the Pennsylvania Office of the State Fire Commissioner (OSFC) has opened the online grant application process for the 2014-15 Fire Company, Volunteer Ambulance Service Grant Program (FCVASGP).  The application was made available online on September 3rd and will remain open until this Friday, October 17th at 4 p.m.  No applications will be accepted after Friday.

All fire companies, volunteer ambulance services, and volunteer rescue squads are eligible to apply for grant funding.  Organizations may apply for grant funding for a combination of up to two projects.  These projects must be for the following:  construction and/or renovation of the fire company’s or ambulance service’s facility; the purchase or repair of fixtures and furnishings necessary to maintain or improve the capability of the company to provide services; the purchase or repair of firefighting, ambulance or rescue equipment; debt reduction associated with the facility or equipment; or the training and certification of members.

Grant applications are available online by clicking here.  For organizations that submitted a grant application last year, you must create a new User ID and Password in order to access the 2014-15 grant application.

Gaming Control Board Annual Report

The Pennsylvania Gaming Control Board (PGCB) recently released their 2013-14 Annual Report.  The Annual Report includes statistical charts on gaming revenue and employment statewide along with similar statistics for each of the twelve casinos in operation statewide.  The report also lists a log of all Board meetings and Executive Session meetings held during the fiscal year, revenue and expenditures for the agency, reports from all of the PGCB’s key bureaus and messages from Chairman William H. Ryan, Jr. and Executive Director Kevin O’Toole.

The 2013-14 Annual Report is available by visiting the PGCB’s website at www.gamingcontrolboard.pa.gov.

Fall Driving Hazards

The Pennsylvania Department of Transportation (PennDOT) is reminding motorists to use caution and be alert for seasonal travel hazards like sun glare, frosty mornings and wet leaves during fall. 

Sun glare can affect commutes in the morning and evening.  As intense sun glare can affect a driver’s vision, motorists can prepare by keeping a pair of sunglasses within reach, removing items from sun visors and by keeping windshields clean. 

As overnight temperatures approach freezing, motorists should watch for frost and icy spots, especially on bridges, overpasses, and shaded areas on roadways.  Drivers should be certain that their vehicles’ windows are clear of frost before driving. 

Wet leaves can be extremely slippery and can cause obscure traffic lines and pavement markings.  Drivers can help reduce the risk of a crash by slowing down and using extra caution on leaf-covered roadways, especially on narrow or winding roads. 

Roadway hazards in the fall also include an increase in deer activity.  Drivers are reminded to watch carefully for deer darting across roadways.  Fall marks the breeding season for deer and deer pay less attention and become bolder as they move around more and travel greater distances seeking mates.  Deer are most active between sunset and sunrise.

For more fall safety tips and other safety information, please visit www.JustDrivePA.com.

RADical Days Underway

Many of our region’s treasured cultural assets are opening their doors at no charge to the public as part of the annual RADical Days, sponsored by the Allegheny Regional Asset District (RAD).  RADical Days runs through November 9th and is designed as a way to thank the public for the sales tax funds that support the region’s culture organizations, parks and recreation, and sports and regional attractions that are funded by RAD.  For a full schedule of events, free admissions and to sign up to receive email and text alerts, please visit www.radworkshere.org and click on the link for RADical Days.

Local Eagle Scout

I wish to congratulate Zachary Tyler Neal on achieving the rank of Eagle Scout, the highest advancement rank available in the Boy Scouts of America.  Zachary is the son of Kirk and Catherine Neal of Brookline.

Zachary is a member of Troop 6, which is sponsored by Church of the Resurrection in Brookline and began his career in scouting in the 4th grade.  His decorated career in scouting includes many honors and awards such as the Arrow of Light Award he received as a Cub Scout, the Ad-Altare Dei Religion , The Order of the Arrow and Scouting National Honor Society Awards.  As a student at Brashear High School, Zachary excelled both in the classroom and in athletics and still found time to serve his community and his church.  Zachary’s Eagle Scout project consisted of organizing and performing the remodeling of chapel at his parish school, a large undertaking that demonstrated his leadership abilities, organizational skills, and thoughtfulness.

It is inspiring to see young people like Zachary make a difference in their community.  Congratulations to Zachary on achieving the rank of Eagle Scout and best of luck in your studies at Duquesne University and beyond!

Duquesne Hosting Health & Wellness Fair

As part of American Pharmacists Month, the Duquesne University Mylan School of Pharmacy is hosting a Health & Wellness Fair tomorrow, from 10 a.m. – 2 p.m. at Market Square in downtown Pittsburgh.  Anyone still needing a flu shot can receive one at the Health & Wellness Fair, although there is a cost.  Also being offered are free blood pressure screenings, free cardiac and diabetic risk assessments, smoking cessation information and vision screenings. 

For more information on the Health & Wellness Fair or Duquesne’s School of Pharmacy, please visit them online at http://www.duq.edu/academics/schools/pharmacy.

Fontana Fact

Lions Club International was founded in 1917 as an organization seeking to improve the community.  Today, it is the largest service club organization in the world with 46,000 clubs and 1.35 million members.  At its 97th annual convention this year, Lions Club International officially kicked off its centennial celebration early with the goal of serving 100 million people by December 2017 through engaging youth, sharing the vision, relieving hunger and protecting the environment.