California Insurer Suspends Mandatory Mail-Order Prescription Plan

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Health insurer Anthem Blue Cross said on Tuesday that it had suspended a deadline requiring clients to enroll in a mail-order prescription program for specialty medicines by March 1, according to a spokesman.

The announcement followed a class action filed by the advocacy group Consumer Watchdog and the law firm Whatley Kallas arguing that the mail-order program would have a discriminatory impact on people living with HIV/AIDS.

"In response to feedback that has been conveyed by our members, which we are in the process of evaluating, we are delaying the March 1 changes in the specialty pharmacy program," said Darrel Ng, an Anthem Blue Cross spokesman.

Consumer Watchdog and Whatley Kallas lawyers praised Anthem Blue Cross's decision. "From our point of view we're really happy with the fact they're willing to put it off indefinitely while we discuss this," said Edith Kallas of Whatley Kallas.

Kallas said she and her colleagues are in mediation with Anthem Blue Cross to reach a solution that would allow patients to have a choice about where to get their medications but have no timeline for arriving at a resolution.

The firm has not withdrawn the class action, filed Feb. 11 in Superior Court of California in San Diego, and a status conference is scheduled for June 21, said Jerry Flanagan, an attorney with Consumer Watchdog.

In the lawsuit, Consumer Watchdog said Anthem Blue Cross enrollees had been notified that as of March 1, 2013, they would be required to obtain "specialty medicines" for HIV/AIDS and other serious illnesses by mail.

The new policy would have a discriminatory impact on people living with HIV/AIDS because they would be denied face-to-face interactions with the pharmacists who monitor their regimens, which are highly complex and subject to change depending on the patient's condition, the lawsuit said. In addition, shipping HIV/AIDS medications by mail raises concerns about patient privacy and delicate medicines that may require refrigeration, the lawsuit said.

The change would have saved money for the health insurer but not for patients, many of whom would lose access to rebates and discounts available through their pharmacies, said Flanagan. Anthem Blue Cross declined to comment on the program's cost-saving benefits.

The insurer sent its enrollees a letter, dated Feb. 15, assuring them that no changes would be made to their coverage until further notice.

The case is John Doe v. Blue Cross of California d/b/a Anthem Blue Cross; Anthem Blue Cross Life and Health Insurance Company; and Does 1-10, inclusive, Superior Court of California for the county of San Diego.

For the plaintiff: Edith Kallas, Whatley Kallas and Harvey Rosenfield, Pamela Pressley, Jerry Flanagan of Consumer Watchdog.

For the defendant: Reed Smith.

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