Date: 01/07/2026
On January 6, 2026, PACEP sent a letter to Highmark expressing serious concerns about their intent to automatically downcode level 4 or level 5 charts based on primary discharge diagnosis beginning in February 2026. Our letter explains how these policies conflict with federal and state prudent layperson protections, disregards the realities of modern emergency medicine, and threatens patient safety.
Our colleagues in medicine, the Pennsylvania Medical Society and the Pennsylvania Osteopathic Medical Association, expressed similar concerns of Highmark's actions by supporting PACEP and signing on to our letter.
PACEP welcomes the opportunity to collaborate with Highmark to reduce system costs that do not compromise patient care. We will keep you updated on future developments.
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