Years of verbal volleys, grabs for physician practices, and disputes over reimbursement rates came to a head this week as the West Penn Allegheny Health System filed suit in federal court against rival University of Pittsburgh Medical Center and insurer Highmark. West Penn Allegheny accuses UPMC and Highmark with antitrust violations that it says have illegally raised prices for consumers in the region while trying "to destroy West Penn Allegheny." The suit lays out various acts against West Penn Allegheny dating back to 2002 that health systems officials say were meant to ensure Highmark's continued dominance in return for higher payment rates for UPMC and Highmark's help to "eliminate" West Penn Allegheny.