“All facets of the Keep Your Doctor campaign have a singular purpose—to smear Highmark and tarnish its reputation, and to lure away its current plan members and encourage them to enroll with UPMC Health Plan or other insurance providers,” the complaint said.
UPMC launched the campaign to punish Highmark for its $475 million deal to acquire West Penn Allegheny Health System, a faltering health system with $748 million in debt, Highmark alleged.
“UPMC's malicious campaign is largely designed to retaliate against Highmark for daring to help keep alive the only alternative large healthcare system in the Pittsburgh metropolitan area that competes with UPMC, West Penn Allegheny Health System,” the complaint said.
UPMC falsely contends Highmark members would pay more and face new access hurdles at UPMC once contracts expire on June 30, 2012, the lawsuit alleged. Contract clauses, known as run offs, require UPMC to honor negotiated rates for the terminated contracts for another year, Highmark said.
“In other words, until at least July 1, 2013, UPMC cannot bill or otherwise attempt to collect from Highmark members amounts for services that are over and above the rates that Highmark and UPMC have agreed upon in the relevant contract,” the complaint said.
“Highmark's lawsuit, while meritless, drives home the point that its current contracts with UPMC will expire on June 30, 2012 and that there will not be a new contract,” UPMC spokesman Paul Wood said in an e-mail. “As for Highmark's interpretation of contractual provisions governing the run-off period, UPMC strongly disagrees and looks forward to presenting the court and the public with the actual contract language.”
Wood said UPMC officials regret the insurer has been unwilling to discuss how to “best unwind our relationship in a manner that minimizes disruption and concern.”
“We want to negotiate a new contract,” said Michael Weinstein, a spokesman for Highmark. “That's what we would like and that's what we are continuing to look for, to have a reasonable and fair contract with them,” he said.