CVS Sued Over Delivery Of HIV Specialty Drugs

By Jacklyn Wille, BLOOMBERG LAW

February 16, 2018

CVS Health Corp. is in the crosshairs of a new lawsuit challenging how it administers prescription drug benefits for people taking HIV/AIDS medications.

The proposed class action, filed Feb. 16 in a California federal court, challenges the insurer’s alleged practice of forcing certain patients to receive HIV specialty drugs through mail order or through shipment directly to an approved pharmacy
for pickup only.

CVS uses financial incentives to encourage employers to sign up their workers for this program, which leaves workers unable to opt out and get their medication at a preferred pharmacy, the lawsuit claims.

This practice threatens patients’ health and privacy, the lawsuit claims, and it forces them to choose between forgoing counseling from trusted pharmacists or paying thousands of dollars more each month for their medication.

The case could implicate the prescription drug benefits of “thousands” of people who rely on HIV/AIDS specialty drugs, according to the complaint. CVS is accused of violating a number of state and federal laws, including the Americans with Disabilities Act, the Employee Retirement Income Security Act, and the nondiscrimination rules of the Affordable Care Act.

Privacy considerations for people taking HIV medications have been a hot topic in recent months. In January, Aetna Inc. agreed to pay more than $17 million to settle accusations that it wrongly disclosed the HIV status of nearly 14,000 people who received prescription drug coverage or related services from the company.

The California insurance commissioner Feb. 15 announced a new investigation into life insurers that allegedly deny coverage to gay men who take HIV/AIDS prevention medication.

A spokesman for CVS didn’t immediately respond to Bloomberg Law’s request for comment.

The case was filed in the U.S. District Court for the Northern District of California by Whatley Kallas LLP and Consumer Watchdog.
The case is Doe One v. CVS Health Corp., N.D. Cal., No. 2:18-cv-01280, complaint 2/16/18.