Antitrust Law Daily Wrap Up, ADVERTISING NEWS: UPMC files false advertising claims against health insurer, (Aug 7, 2013)

By Jody Coultas, J.D.

The University of Pittsburg Medical Center (UPMC) has filed suit against Pennsylvania’s largest health insurer Highmark, Inc. for false and misleading advertising in violation of the Lanham Act and Pennsylvania law.

Highmark’s television advertising campaign stated that UPMC will “deny access,” “close its doors,” or otherwise not allow “Highmark health insurance customers” or “Western Pennsylvania families” to “use UPMC after 2014.” Senior citizens were featured complaining that UPMC feared competition, using the terms “monopoly” and “community asset.” The ads were allegedly part of a larger campaign by Highmark to take 41,000 inpatient admissions away from UPMC and lure them to its health network.

The complaint highlighted a number or reasons the advertising was false, and Highmark’s supposed motivation for the ads. UPMC stated that Highmark subscribers will have full, out-of-network access to UPMC’s facilities and physicians and in-network access to certain UPMC facilities and physicians after 2014. Western Pennsylvania families and current Highmark subscribers will have in-network access to UPMC’s facilities and physicians through other insurers. Finally, all Medicare and Medicare Advantage subscribers and patients will have in-network access to UPMC hospitals and physicians and will not be affected by the changes in the contractual relationships between Highmark and UPMC.

UPMC alleged that Highmark needed to move patients and subscribers away from UPMC to support its new business model. The complaint also alleged that Highmark’s advertising campaign misrepresent and misstate the parties’ relationships, contained numerous false and misleading statements, and was likely to influence purchasing decisions, confuse consumers, and injure UPMC. Highmark also allegedly refused to agree to cease and desist distribution of its false and misleading advertisements.

The complaint in UPMC v. Highmark, Case No. 2:13-cv-01130-CB, was filed in the federal district court in Pittsburgh August 5, 2013.

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