SANTA MONICA, CA — Under a recent settlement of two lawsuits, members of health plans issued by Aetna, Inc. and its subsidiary, Coventry Health Care, Inc., are no longer required to obtain their HIV/AIDS medications by mail-order and may obtain those medications at retail pharmacies. The class action lawsuits alleged that Aetna and Coventry’s requirement that members obtain HIV and AIDS medications by mail threatened their health and privacy.
Members may also recover certain out of pocket costs associated with obtaining medications to treat HIV and AIDS by mail. Notices and claim forms were mailed to members on July 28. Completed claim forms must be postmarked no later than September 29, 2017 to be valid. The settlement applies to individual and group Aetna plans and individual Coventry plans.
Download the settlement agreement here: https://www.consumerwatchdog.org/sites/default/files/2021-05/2017-02-23%20Settlement%20Agreement%20FINAL.pdf
Due to the complex nature of HIV/AIDS drug regimens, patients rely on their local pharmacists who, working directly with patients, monitor potentially life-threatening adverse drug interactions and side effects. Pharmacists also provide essential advice and counseling that help HIV/AIDS patients and families navigate the challenges of living with a chronic and often debilitating condition.
HIV/AIDS patients also expressed serious concerns about a loss of privacy associated with mail-order. Patients who live in apartment buildings or have medications delivered to their work place have expressed alarm that neighbors, co-workers, and employers, who do not know that the recipient has HIV/AIDS, would come to suspect that they are seriously ill.
“We are glad that Aetna and Coventry listened to the serious and heartfelt concerns of their customers who depend on local pharmacists for their life-saving medications,” said Edith Kallas of Whatley Kallas, LLP.
If members have questions about their pharmacy options, including obtaining HIV and AIDS medications at a retail pharmacy, please call either 800-326-5608 for Aetna members or 800-378-7040 for Coventry members. If members have questions about the claims process they may contact the settlement administrator at: 866-715-7946.
“This settlement brings to a close a nerve-racking episode for patients with HIV and AIDS who faced uncertainty in accessing their life-sustaining medications,” said Jerry Flanagan, Litigation Director for Consumer Watchdog.
Whatley Kallas, LLP and Consumer Watchdog have settled four similar lawsuits against Anthem Blue Cross of California, United Healthcare, Cigna, and Anthem, Inc. The Podhurst Orseck, P.A., firm was counsel in the Cigna and Coventry matters. Under these settlements, HIV/AIDS patients have a right to obtain HIV/AIDS medications from retail pharmacies.
-30-
Consumer Watchdog is a nonpartisan consumer advocacy organization with offices in Washington, D.C. and Santa Monica, CA. Visit us on the web at: http://www.ConsumerWatchdog.org
The lawyers of Whatley Kallas, LLP have been repeatedly recognized in legal publications, such as The National Law Journal and American Lawyer, by their peers and by leaders of organized medicine for their work in the healthcare field. For more information, go to: http://www.whatleykallas.com/
Miami-based Podhurst Orseck, P.A., established over four decades ago, is a top flight boutique trial and appellate firm focusing its practice on tort litigation matters including aviation, products liability, serious personal injury, and wrongful death claims, as well as complex commercial litigation and white collar defense. Additionally, the firm has a strong appellate practice, handling appeals for its own attorneys and attorneys throughout the nation, in various state and federal appellate courts, including the United States Supreme Court. The firm has consistently received an AV-Rating from Martindale-Hubbell Law Directory, the highest possible rating, based on legal ability and general ethical standards. For more information, please visit http://www.podhurst.com
