X

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.

Join CMA Today!

Explore why over 43,000 California physicians have joined CMA to advocate for patients, the medical profession and the future of health care.

Was this page helpful?