The National Health Law Program (NHeLP) and The AIDS Institute filed a complaint yesterday with the Office for Civil Rights of the United States Department of Health and Human Services (HHS OCR) alleging that four Florida insurers are discriminating against people with HIV/AIDS. The complaint claims that the insurers are creating prescription drug policies that discourage people with HIV/AIDS from using their plans, which violate the Affordable Care Act (ACA) and federal civil rights laws.
“The ACA provides robust consumer protections, including putting an end to discriminatory practices by health insurers,” said Wayne Turner, NHeLP staff attorney, in a statement yesterday. “But these insurance plans are running afoul of that by placing all HIV/AIDS medications in the highest tiers with exorbitant co-insurance and co-pays, and instituting other barriers to obtaining commonly prescribed HIV/AIDS medications. The companies are going out of their way to discourage people with HIV/AIDS from enrolling in their plans–a blatantly illegal practice.”
The four insurers noted in the complaint – Coventry One, Cigna, Humana and Preferred Medical – are alleged to have placed all HIV/AIDS medications in the highest drug tiers and to require expensive co-insurance and co-pays, high up-front costs, and prior authorization. For example, Humana requires that members spend a $1,500 deductible and then contribute 50 percent towards the cost of their HIV/AIDS medication – which can cost over $2,000 for a one-month supply.
The groups are calling on the HHS OCR to investigate the plans and require them to take corrective actions. They want to send a strong message to other plans to prevent this tactic from spreading, which “would make insurance coverage impossible for people with HIV/AIDS, and jeopardize their health and well-being,” continued Turner.