Dive Brief:
- Until now, Cigna has had a policy stating that patients buying HIV drugs must use its mail-order pharmacy program in order to obtain the drugs.
- Consumer Watchdog sued Cigna on behalf of a man who lives in Fort Lauderdale, FLA. The suit, which was filed in Florida federal court, alleges discrimination and violation of the Affordable Care Act (ACA).
- Cigna has decided to settle the suit, and as of December 1, patients on the insurance giants' plans will be able to obtain drugs from any in-network pharmacy.
Dive Insight:
Under the provisions of the ACA, forcing patients to receive their HIV medications through a mail-order pharmacy program is discriminatory because it is something that only applies to people with HIV. Moreover, patients who use this program run the risk of having their privacy compromised and may also have to pay more for their drugs. Plus, they don't have the opportunity to interact face-to-face with pharmacists who might be able to support them and provide additional information.
The net result of this class-action suit is that patients, who are being treated for HIV, will be able to use any in-network pharmacy they choose and those who paid more than they would have through a local pharmacy will be able to seek reimbursement for the difference.
This is another win for Consumer Watchdog, which also won similar cases against Anthem Blue Cross in June 2013 and United Healthcare in July 2014.
Recommended Reading
Reuters: Cigna drops mail-order requirement for HIV drugs in settlement
