Judge hears arguments in ongoing battle between Highmark, UPMC
By Brian Bowling
Published: Friday, Jan. 4, 2013, 1:20 p.m.
A federal judge should throw out UPMC's claim that Highmark Inc. and West Penn Allegheny Health System conspired to keep other insurers out of Western Pennsylvania and damage UPMC's business because the claim is not plausible, a lawyer for Highmark argued on Friday.
UPMC demonstrated in 2010 that it can bring in insurers because it signed contracts with several after its falling-out with Highmark, said Margaret Zwisler, one of Highmark's attorneys.
“It was entirely up to them” whether other insurers could operate in the region, she told U.S. District Judge Joy Flowers Conti.
Highmark and West Penn Allegheny have pending requests to dismiss UPMC's lawsuit, which is one of several lawsuits that have been filed since 2009, when West Penn Allegheny sued Highmark and UPMC with similar claims.
Conti likened the battle between Highmark and UPMC to a fight between two 800-pound gorillas, and the lawyers seized on that analogy in their arguments.
Zwisler contended that UPMC is the gorilla with the market dominance to push around competitors.
Leon DeJulius, one of UPMC's attorneys, argued that Highmark was the gorilla in 2002 when it forced a contract that kept the hospital system from signing contracts with other insurers for 10 years.
The contract forced UPMC to accept lower reimbursement rates from Highmark than it would have received in a competitive market. The fact that the hospital system grew despite the unfavorable contract does not exempt Highmark from UPMC's antitrust claim, DeJulius said.
Zwisler countered that UPMC could have ended the contract in 2009 but extended it through 2012. UPMC decided to get out of the contract only when Highmark announced its intent to acquire West Penn Allegheny, she said.
The lawyers agreed that West Penn Allegheny is not the gorilla.
Barbara Sicalides, West Penn Allegheny's lawyer, said employers will buy an insurance plan that does not include West Penn Allegheny's facilities and doctors, but they won't buy one that does not include UPMC's facilities and doctors.
“We can't harm competitors,” Zwisler said. “We don't have that power.”
Conti took the arguments under advisement.
Brian Bowling is a staff writer for Trib Total Media. He can be reached at 412-325-4301. or firstname.lastname@example.org.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Kovacevic: Still waiting on Crosby, Malkin
- Rossi: Lack of together time showing for Penguins’ defense
- 3 ejected after Pirates, Brewers brawl
- Fleury a bright spot among struggling Penguins in playoffs
- Starkey: Penguins’ arrogance astounding
- Draftees’ longevity key for NFL success
- Police fatally shoot man in Wilkinsburg after chase
- Garden Q&A: Firecracker vine OK for trellis?
- Washington County crash causes chemical spill into Chartiers Creek
- Population expansion in Western Pennsylvania hinges on immigrants
- Attorney wants lesser term for woman in Greensburg torture death