Anthem Blue Cross has halted implementation of a program that would have required policyholders to use a mail-order pharmacy to acquire certain drugs, the Los Angeles Times reports.
About Anthem's Rx Program
Last fall, Anthem said it was changing its prescription drug program so that anyone seeking medication that qualified as a "specialty" drug would be required to use a mail-order pharmacy approved by the insurer (Lazarus, Los Angeles Times, 2/19).
However, patients seeking to fill other types of prescriptions still would be able to use their regular retail pharmacy.
Details of Lawsuit
Consumer Watchdog filed a class-action lawsuit against Anthem, alleging that the new program would discriminate against individuals with HIV/AIDS.
Jerry Flanagan — a Consumer Watchdog attorney — said that the change in policy represented "exactly the kind of targeting and discrimination barred under the Civil Rights Act in California."
According to Flanagan, many low- and middle-income individuals with HIV/AIDS depend on programs established between specialty pharmaceutical companies and retail pharmacies that help pay for deductibles and copayments.
In response to the lawsuit, Anthem said that the policy change was not discriminatory because the list of specialty medications included drugs for various conditions and not just for HIV/AIDS. It said, "Anthem's policies do not discriminate on the basis of disease states, and they are reasonable and compliant with applicable laws" (California Healthline, 1/16).
AG's Response to Program
California Attorney General Kamala Harris (D) said that any rule that would force some individuals to buy their prescription drugs from a certain pharmacy but allow others to shop elsewhere could violate state law.
Lynda Gledhill — spokesperson for Harris — said, "California law clearly states that no one can be discriminated against because of a medical condition," adding, "If patients are being required to get their prescriptions from a certain pharmacy because of their condition, that is likely illegal."
Details of Anthem's Decision
Anthem is sending letters to policyholders who use specialty medications that explain they are not required to buy their drugs from CuraScript, an online pharmacy.
The letter states, "Because Anthem has received feedback about this Specialty Pharmacy program from its members, we are evaluating that input to better serve our members and, for the time being, have eliminated the stated March 1, 2013, required date to use CuraScript for such additional specialty medications" (Los Angeles Times, 2/19).