Moody's Investors Service revised its outlook for West Penn Allegheny Health System bonds to developing from negative while affirming its deep-into-junk-level Ca rating, as the teetering provider navigates through its affiliation agreement with Highmark Inc.

The move affects about $752 million of Series 2007 fixed-rate bonds that West Penn issued through the Allegheny County Hospital Development Authority. It was one of the largest speculative-grade new issues in the municipal marketplace, though ratings have gone even lower amid West Penn's continuing struggles.

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