Court settlement allows BC HIV/AIDS patients to opt-out of mail order pharmacy program

June 06, 2013

Anthem Blue Cross patients with HIV/AIDS may "opt-out" of a program that would have required them to obtain their medications by mail order under a court settlement announced last week.

The lawsuit, filed in January in San Diego Superior Court, alleged that Blue Cross's mandatory mail order program announced late last year illegally targeted HIV/AIDS patients, threatening their health and privacy.

California State Insurance Commissioner Dave Jones applauded the court-approved settlement between Anthem Blue Cross and Consumer Watchdog regarding how policyholders receiving treatment for HIV/AIDS purchase their medications.

"Today's court decision, which eliminates the requirement that Anthem policyholders receiving treatment for HIV/AIDS only use a mail order pharmacy for their medication is another important win for consumer protection in California," said Jones. "Pharmacists are an extension of a patient's treatment team, providing medication expertise and consultation that a mail order pharmacy may not be able to offer. Patients should not have to rely on an off-site vendor call center when they need assistance with medication management."

HIV/AIDS patients had expressed serious concerns about a loss of privacy associated with the proposed mail order program. HIV/AIDS specialty medications often are delivered in refrigerated containers. Patients who live in apartment buildings or have medications delivered to their work place expressed concern that neighbors and co-workers who were not aware of their condition would come to suspect that they were seriously ill. Mail-order shipment also presents the risk of lost or stolen medications.

Under the settlement, any Blue Cross patient prescribed HIV/AIDS medications currently or in the future, has an unconditional right to opt-out of the Blue Cross mail-order program at any time. Blue Cross patients who opt-out can continue purchasing such medications at a retail pharmacy.

Beginning June 1, Blue Cross patients can opt-out of the mail-order program by contacting Blue Cross's mail-order pharmacy, CuraScript, on a dedicated toll-free telephone line. Consumers currently prescribed such medications should have received a letter in the first week in June from Blue Cross providing this telephone number and additional instructions for opting-out.

Blue Cross patients may also submit a claim for reimbursement of any out-of-pocket costs incurred as a result of enrolling in the CuraScript mail-order program between December 1, 2012 and May 31, 2013.


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