HomestoryHIV/AIDS › Patient Sues Aetna Over Mail-Order-Only Policy For AIDS Drugs

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Patient Sues Aetna Over Mail-Order-Only Policy For AIDS Drugs

ASSOCIATED PRESS
http://www.bostonglobe.com/business/2014/12/23/consumer-group-sues-aetna-alleges-discrimination/3T8Z5OWjuro6MnQvYOIrXO/story.html

SAN DIEGO — A consumer advocacy group has filed a lawsuit against Aetna Inc., saying a new policy violates the privacy of people with HIV and AIDS by making them get their medications from its mail-order pharmacy.

Consumer Watchdog, which sued Friday in federal court, says mailing the drugs puts patients’ privacy at risk and is is not a reliable way to ensure people get their medications on time.

The group alleges the policy violates the federal health care law because it discourages people with HIV and AIDS from signing up for the company’s insurance.

Aetna spokeswoman Cynthia Michener said the policy is part of a strategy to keep health plans affordable. People can opt out, she said. ‘‘To opt out, members only have to call the number on their ID card,’’ she said in an e-mail. ‘‘Requests will be processed the same day.’’

The plaintiff, an unnamed San Diego man says that it he opts out he would face exorbitant costs, since his local pharmacy would be considered out-of-network, said Consumer Watchdog attorney Jerry Flanagan.

The plaintiff fought with the company for more than a month to be allowed to continue going to his local pharmacy at no extra cost, Flanagan said. He says the policy violates the Affordable Care Act, which aims to end discrimination against patients based on their health conditions.

‘‘Requiring health plans to offer coverage for patients with a preexisting condition means little if the insurer can charge these patients exorbitant co-insurance or only cover care through inconvenient and ineffective mail-order requirements that put the patients’ health and privacy at risk,’’ he said.

In May, two health organizations filed a similar complaint with federal officials, alleging some Florida insurance companies were violating the law by structuring insurance plans to discourage consumers with HIV and AIDS from choosing those plans because they wouldn’t be able to afford the high co-insurance rates.

The insurer Cigna later agreed to change its prescription drug policy.

In the past, Consumer Watchdog filed similar lawsuits against two other insurers, United Healthcare and Anthem Blue Cross of California. Both cases were settled, and members can opt out of the mail-order requirement.