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BlueCross files in federal court over Catholic Health ads

BlueCross BlueShield of Western New York this afternoon filed a complaint in federal district court accusing Catholic Health System of making false and deceptive statements in advertising that targets one of the insurer’s products.

The legal filing ratchets up a simmering, weeks-long dispute between the region’s largest insurer and its second-largest hospital system over a Medicare Advantage plan offered by BlueCross BlueShield that excludes non-emergency treatment at Catholic Health hospitals.

Since BlueCross BlueShield introduced the narrow-network Medicare Advantage plan last month, Catholic Health has waged an aggressive marketing campaign to let consumers know the Senior Blue HMO Select plan excludes most care at its hospitals. The campaign includes a billboard, radio spots, newspaper advertisements and notices in church bulletins.

BlueCross BlueShield, in its complaint, argues that Catholic Health “has engaged in a wide-spread, systematic campaign to disseminate literally false, misleading and defamatory advertisements.”

The insurer’s objections center on the fact that, in its advertisements, Catholic Health states the Medicare Advantage plan “excludes all Catholic Health facilities” when emergency care at system hospitals is covered.

And, the complaint states, care at a Catholic Health facility provided by a primary care physician who accepts BlueCross BlueShield insurance also would be covered.

The insurer said its business and its reputation have been harmed and it seeks an award of damages to be determined at trial.

Catholic Health spokesman Chuck Hayes said this afternoon that system officials could not comment because they had not yet seen the complaint.

Catholic Health has argued BlueCross BlueShield wasn’t upfront with its members about the fact the plan excludes most care at the system’s hospitals, and its advertising campaign is meant to get the full details out to its patients.

BlueCross BlueShield, however, responds that current and new members are receiving ample notice that the Senior Blue HMO Select plan is a tailored network plan that excludes the Catholic Health system facilities.

The insurer said the plan was designed to provide a lower-cost option for Medicare Advantage members, who still may see any doctor or specialist within the Senior Blue network.

The hospitals that are part of the Senior Blue HMO Select plan include Buffalo General Medical Center, Roswell Park Cancer Institute and Erie County Medical Center.

Emergency room visits to a Catholic Health hospital will be covered, the insurer said. Catholic Medical Partners physicians and Mount St. Mary’s Hospital in Lewiston also are included in the plan.

Senior Blue HMO Select is one of five BlueCross BlueShield Medicare Advantage plans offered in Erie County for 2015. It replaces the existing Senior Blue 650 Part D plan, which did include the Catholic Health System facilities.

The other four, higher-premium plans offered by BlueCross BlueShield here do include the Catholic Health network.