Lawsuit: Anthem mail-order pharmacy program discriminates

Anthem Blue Cross of California is facing a lawsuit for allegedly discriminating against certain members with chronic diseases, including HIV/AIDS and cancer, by forcing them to obtain prescriptions using a mail-order pharmacy.

The lawsuit, which was filed Friday by consumer advocacy group Consumer Watchdog in San Diego Superior Court, claims Anthem's new policy banning seriously ill members from using local pharmacies to get medications violates California state civil rights law, KPBS reported.

Another negative impact of Anthem's new policy, which goes into effect March 1, is that the targeted members would face rising costs if they choose to continue filling their prescriptions through local pharmacies because they will be visiting an out-of-network venue and required to pay full price for the drugs, the lawsuit claims.

The problem is that Anthem is only targeting a few serious illnesses and allowing other members with chronic diseases like diabetes to continue using the pharmacy of their choice, reported the Los Angeles Times.

What's more, the suit says, the policy could result in members' losing access to their pharmacists, who often monitor potentially life-threatening adverse drug reactions. But Anthem spokesman Darrel Ng told Law360 that the insurer's members with HIV/AIDS receive 24-hour access to social workers, community support resources, nursing assistance and pharmacists through the mail-order pharmacy.

"This is being done with the knowledge of our regulator and applies to several hundred different drugs for many medical ailments," Ng said. "Anthem's policies do not discriminate on the basis of disease states, and they are reasonable and compliant with applicable laws."

To learn more:
- read the Law360 article (subscription required)
- see the KPBS article
- check out the Los Angeles Times article