Fort Lauderdale, FL — CIGNA, one of the nation’s largest health insurers, is discriminating against patients with HIV/AIDS and attempting to circumvent the central reform of the Affordable Care Act, according to a national class action lawsuit filed late yesterday.
The lawsuit, JOHN DOE v. CIGNA was brought by a Ft. Lauderdale resident.
The so-called “guaranteed issue” provision of the ACA ensures access to health insurance for all patients regardless of their health condition. However, according to the lawsuit CIGNA is discouraging patients with HIV/AIDS from enrolling in or remaining enrolled in CIGNA health plans by forcing them to obtain their medications by mail-order and risk their health and privacy.
The lawsuit was filed by Whatley Kallas, LLP, Consumer Watchdog—a non-profit consumer group, and Podhurst Orseck P.A. located in Miami, Florida.
Whatley Kallas, LLP and Consumer Watchdog have settled two similar suits against United Healthcare and Anthem Blue Cross. Under those settlements, HIV/AIDS patients have a right to opt-out of the mail-order program.
“What’s the good of an insurance policy if you can’t get the medications you need to stay alive when you need them or are forced to risk your health and privacy to use it?,” said Consumer Watchdog Lead Staff Attorney Jerry Flanagan.
Download the lawsuit, which was filed in Florida federal court here: http://www.consumerwatchdog.org/resources/doevcigna_healthlifeinsurancecocomplaint.pdf
“Patients should have a choice about how they obtain their life-saving medications and CIGNA should do the right thing and follow the lead of other health plans that have now provided that choice,” said Edith Kallas of Whatley Kallas LLP.
CIGNA’s discriminatory treatment of HIV/AIDS patients violates the Affordable Care Act, Americans with Disabilities Act, and the Employee Retirement Income Security Act (“ERISA”), according to the lawsuit:
• Due to the complex nature of HIV/AIDS drug regimens, patients rely on their community pharmacists who, working directly with patients, monitor potentially life-threatening adverse drug interactions and side effects.
• Mail-order delivery of these medications is not a viable option for many patients and can raise major privacy implications, particularly for those individuals who have not revealed their medical condition to employers, co-workers, friends, and family members.
• Because there is no cure for HIV/AIDS, the virus continually mutates around the medications prescribed to treat it, requiring constant face-to-face monitoring and immediate provision of new medication regimens to address changes in the disease.
• Community pharmacists, who often have greater contact with HIV/AIDS patients than physicians and know their complete drug regimen provide essential advice and counseling that help HIV/AIDS patients and families navigate the challenges of living with a chronic and often debilitating condition.
• CIGNA’s mail-order pharmacy replaces these life-saving interactions with an 800 number that places the burden of securing life-sustaining medications on chronically ill patients.
• HIV/AIDS patients must renew their prescriptions each month—and work their way through automated robocalls, messages, multiple call center staff, or Internet web pages—increasing stress and fatigue for patients who are literally fighting to stay alive, exacerbating their condition.
• The use of mail-order providers also creates the very real risk of delayed, lost or stolen shipments, resulting in dire consequences for many patients who must strictly adhere to their medication regimes or face serious illness or death.
• If HIV/AIDS patients do not obtain their specialty medications by mail, they must pay full-price for their medications—easily thousands of dollars or more each month—to purchase their medications at their community pharmacy.
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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 www.podhurst.com