With a March 1 signup deadline looming and California HIV/AIDS patients girding for the worst, health insurer Anthem Blue Cross backed off and suspended a program that would have forced them to purchase their medications through the mail.

State regulators had asked the insurer to reconsider, but a class-action lawsuit filed last month by Consumer Watchdog and the law firm Whatley Kallas got its attention. The suit argued that barring the patients from buying drugs at their local pharmacies would endanger their health and threaten their privacy.

Many of the drugs need refrigeration, and delivery to a house, apartment or office could be problematic for more than just safety reasons. Neighbors and co-workers would weren’t aware of a patient’s health situation would be alerted to the seriousness of the condition.  

HIV/AIDS users also rely on personal contact with pharmacists for monitoring and adjustments in medication and that would be replaced by “an 800 number outsourced to an unidentified vendor at an unknown remote location.” The insurer uses CuraScript, a mail-order pharmacy in Florida.

The suit argued that Anthem Blue Cross “appears to have no failsafe procedure in place” in case critical medication is “delayed, lost or stolen.”

In addition to losing the personal contact, patients would lose access to discounts they may be receiving at local pharmacies unless they can obtain a hardship waiver from Anthem Blue Cross every six months, according to the lawsuit. If they use a retail pharmacist, the transaction would be considered out-of-network and cost considerably more money.

The lawsuit called the mail-order directive discrimination over a medical condition, barred by the Unruh Civil Rights Act since 1959. The “specialty medications” targeted by the insurer also would impact patients with cancer, autoimmune conditions and other diseases. But the main thrust of the lawsuit was aimed at protecting HIV/AIDS patients.

The lawsuit takes a harsh stance against Anthem Blue Cross, accusing the company of “engaging in this program in a quest for further profits, and thus appears to be putting such profits over the safety and needs of their enrollees.” But they were much kinder when the insurer announced the suspension.

“Blue Cross should be commended for listening to the serious and heartfelt concerns of their customers who depend on local pharmacists for their life-saving medications,” attorney Edith Kallas said. “We look forward to working with Blue Cross.”

–Ken Broder

To Learn More:

California Insurer Suspends Mandatory Mail-Order Prescription Plan (by Anna Louie Sussman, Thomson Reuters)

Blue Cross Suspends Mandatory HIV/AIDS Drug Mail Order Program (Consumer Watchdog)

Anthem's Mail-Order Policy May Have Crossed a Legal Line (by David Lazarus, Los Angeles Times)

John Doe v. Blue Cross of California et al (San Diego County Superior Court of California) (pdf)