In response to consumer complaints and a class action lawsuit on behalf of HIV/AIDS patients in California, Anthem Blue Cross has agreed to suspend a program that would have barred patients from purchasing certain specialty medications at local pharmacies.  Under the program, patients would have been required to obtain their medications by mail order, threatening their health and privacy according to the lawsuit.

Blue Cross announced the suspension of the mail order program in a letter arriving in consumer’s mailboxes this week.  Download a copy of the letter here.

“The deferment of the mail order program is great news for thousands of Blue Cross customers with HIV/AIDS who were facing risks to their privacy and health,” said Jerry Flanagan, staff attorney for Consumer Watchdog.

The lawsuit, filed last month in San Diego Superior Court by Consumer Watchdog and Whatley Kallas LLC, alleges that the mandatory mail order program illegally targets HIV/AIDS patients. The lawsuit further alleges that due to the complex nature of HIV/AIDS drug regimens, patients rely on their local pharmacists who, working directly with the patients, monitor potentially life-threatening adverse drug interactions, and provide essential advice and counseling that helps HIV/AIDS patients and their families navigate the challenges of living with a chronic and often debilitating condition.  

In addition to the health concerns raised by the change in their continuity of care, HIV/AIDS patients have expressed serious concerns associated with a loss of privacy due to the proposed mail order program. For example, HIV/AIDS specialty medications often need to be delivered in refrigerated containers. Patients who live in apartment buildings or need to have their drugs delivered to their place of employment are concerned that neighbors and co-workers who are not aware of their condition will come to suspect that they are seriously ill.

Under the mail order program announced by Blue Cross in December and slated to go into effect on March 1, 2013, HIV/AIDS patients’ insurance policies would have no longer covered medications purchased at local pharmacies.

The deferment is intended to allow Blue Cross, Consumer Watchdog, and Whatley Kallas LCC time to develop a more consumer friendly program.

“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,” said Edith Kallas of Whatley Kallas LLC. “We look forward to working with Blue Cross to ensure its mail order program benefits consumers without unfairly targeting its most vulnerable patients and providing them appropriate opportunities to choose what is best for them.”

Download the lawsuit filed by Consumer Watchdog and Whatley Kallas, LLC here.

A new lawsuit filed in California this week alleges that Blue Cross is discriminating against HIV/AIDS patients, among others, forcing patients with certain preexisting conditions to use mail-order only for their pharmacy care.

From the Fox 5 San Diego report:

Under the new program, HIV/AIDS patients’ insurance policies will no longer cover medications at local pharmacies, according to the suit filed Friday by Consumer Watchdog, a nonpartisan consumer advocacy organization with offices in Washington, D.C., and Santa Monica.

HIV/AIDS patients will instead be required to purchase their prescription drugs from a mail order pharmacy, while Blue Cross members who do not suffer from one of the targeted conditions under the same policies will continue to enjoy full access to the pharmacies of their choice, according to the suit.

Health plans and pharmacy benefit managers (PBMs) forcing patients to lose access to their trusted community pharmacist and instead receive medications through the wasteful mail order system deprives these patients of a much needed health care provider.

For patients with chronic illness, their pharmacist is a key player in their ongoing care, and often the provider they speak to the most. For a plan to deny them of that relationship is harmful.

To learn more about how mail-order pharmacies hurt California patients, visit Pharmacy Choice and Access Now today!

In its quest for more profits, Anthem Blue Cross has begun telling patients who have very serious diseases and need so-called “specialty drugs” that they cannot use their local pharmacy where many have long term relationships, but must instead order their life-saving medications from a mail-order pharmacy.

As Los Angeles Times Consumer Columnist David Lazarus recently noted, specialty drugs are used for complex conditions and can cost thousands of dollars a month. Patients suffering from chronic diseases like HIV, cancer, and hemophilia use such medicines.

In the Los Angeles area HIV patients are particularly hard hit by Anthem’s unilateral decision that after Jan. 1, patients needing specialty drugs to treat their conditions must buy them from mail-order pharmacy CuraScript.

In a letter to patients, the insurance giant wrote:

“Using a retail pharmacy will be considered going out-of-network. And your plan doesn’t have coverage for that. So you’ll have to pay the full price of the drug.”

According to Lazarus Jacques Liberman, 57, of Cathedral City received one of the letters the other day. He is HIV-positive and takes a drug called Atripla to help prevent his condition from transforming into full-blown AIDS.

“Who is Anthem to tell me where I have to buy my medicine?” Lazarus quoted him as saying. “Why should I have to buy it from some mail-order company instead of the drugstore that I have been going to for a long time?”

But it’s more than just an in infringement on personal freedom. Patients who need specialty medicines suffer from complex disease that require complex treatment. The pharmacist is virtually a member of the treatment team offering advice and closely monitoring the patient’s condition.

David Balto, a Washington attorney who represents some of the specialty pharmacies, explains the relationship like this:

“Specialty pharmacies, the pharmacies that carry these rare, expensive drugs, build strong personal and clinical relationships with their patients, making sure that they receive the drugs they need when they need them. Most also provide a full slate of advising and counseling services to help patients and their families navigate the challenges of living with a chronic and often debilitating condition. Many specialty pharmacies also have programs to help low-income patients afford their ever rising co-pays.”

Anthem proposes to replace that relationship with an 800 number. Anything for a buck, I suppose.

What’s not clear yet is what can be done to stop this abuse. Consumer Watchdog is investigating.  If you’ve been affected by the change please let us know.

On June 16, California Church IMPACT will hold a protest outside the capitol to protest the cuts.

Join us Tuesday, June 16 from 9 a.m. to noon in Sacramento to have a huge faith rally on behalf of every single human life that is being thrown away to balance our budget!  

Every single social support in welfare, health, and even prenatal care is being ripped out of the budget to prevent having to revisit tax increases on those with resources.   We MUST be present to witness against this disgusting and utterly immoral action!

We will begin our march at the Capitol from 10 a.m. to 11 a.m. followed by visits by you to YOUR legislator.  You will carry the message:  “One who oppresses the poor to increase his or her own wealth, and one who gives gifts to the rich – both come to poverty.” (Pr.22:16) Those already living on the thin edge due to the economic crisis are now being pushed into abject misery, homelessness, even loss of life.  This is not an exaggeration since even some dialysis service is being eliminated, a sure and certain death sentence for those with kidney failure.

Check the full details here.

we get further into the budget mess, we hear a lot about it in what is left of the Sacramento media. We hear a lot about it in traditional activist circles.  But the message has only peripherally escaped beyond that.  Getting people to understand has to come through a full court press from all interested parties.  That means mainstream media, blogs, emails, letters to the editor, and person to person communication.

But all that work cannot exempt any of us from doing the good ol’ fashioned protest.  In San Francisco and Sacramento today, activists will protest the cuts to HIV/AIDS services and education.  At 10 AM, a broad coalition will join together at SF City Hall to make it clear that these drastic cuts in HIV education are simply not acceptable.  A bunch of people will then hop on a bus on their way to Sacramento for a protest at the State Capitol at 1:30 PM.  I’ll post some pictures from the festivities later this morning.

But it simply must go beyond single silo-based activist protests. We can get tens of thousands of people to show up to protest Prop 8, yet HIV funding cuts aren’t nearly as good of a draw.  Look, both issues should matter to the LGBT community, and frankly, to progressives generally. Further, we need to protest the budget cuts in general.  Education funding cuts affect a profound array of issues, as do health and services cuts.  California’s leaders must understand that their constituents care about a functioning government, and while not the only way, they need to see it in the protests.

So, there will be an array of protests over the next few weeks. If you have details on anything, please post it in the comments.  And if you are in SF, please join me for a the HIV/AIDS protest at 10 AM at City Hall.

XPosted 4/7/2008 11:46 PM PDT on MyDesert.com by BluePalmSpringsBoyz

Overheard Saturday night at the Democrats of the Desert Awards Banquet at the Las Rancho Palmas Resort, the decision to seek to close the Cathedral City medical marijuana clinic was made by Mayor Kathy DeRosa (R), Mayor Pro Tem Charles England (R), and Councilmember Chuck Vasquez (R-Closet Case) who voted to close the clinic.

Councilmember Greg Pettis (D), Candidate for the CA 80th Assembly District, and Councilmember Paul Marchand (D), Candidate for Mayor of Cathedral City, voted to support the clinic but were overruled by the Republican majority on council.  In fact, Pettis was slated to appear at an event to support medical marijuana patients at Copy Kats last night, but the event was postponed.

More below the flip…

According to a Cathedral City source for background, Cathedral City council, under the auspices of DeRosa, has a policy to apparently vote on issues in private and to not announce the individual votes of the councilmembers.  This is really “Small Town in Mass Society” (Vidich) mentality.  Anyway, the Desert Sun never printed who voted what way as the specific vote was never announced as per usual.

Seems that DeRosa, England, and Vasquez are out of step with Californians overall and Cathedral City residents who favor keeping the clinic open to service patients diagnosed with cancer, chronic pain, glaucoma, HIV/AIDS, etc.  Isn’t this the same party that opposes stem cell research?  What kind of family values does the Republican party really have?

The 2007 United States Conference on AIDS (USCA) is meeting in the Palm Springs Convention Center in Palm Springs, CA from November 7 – 10.  Palm Springs is the smallest city to ever host the conference.  However, this marks the largest attendance of health care experts, service providers and those living with AIDS thus far in the 11 year history of the USCA.  The USCA has had an impressive list of sessions, including institutes, seminars, workshops, roundtables, and posters.

The Desert Sun reported on the official Mayors’ Welcome Reception at Hotel Zoso:

Hundreds of people, gathered in Palm Springs for the country’s largest annual AIDS conference, raised their index fingers to the sky Thursday night.

One.

For the millions of ones lost to the epidemic. For the millions of ones who survive. And, for the millions of ones who continue the fight.

It was a common message shared during an otherwise festive cocktail party – the official Mayors’ Welcome Reception at Hotel Zoso – for the National Minority AIDS Council’s 2007 United States Conference on AIDS.

“Too many people, for a long time, have (believed) that this is a gay man’s disease,” said Clayton Barbour, medical director of the Desert AIDS Project’s Wells Fargo HIV Health Center.

“But we are a diverse community. And everyone is at risk.”

The USCA 2007 Sponsor is the National Minority AIDS Council (NMAC).  NMAC was established in 1987, and is the premiere National organization dedicated to developing leadership within communities of color to address the challenges of the HIV/AIDS epidemic.  For additional information on NMAC, send an e-mail to [email protected], or contact NMAC offices directly at NMAC – Main Office, 1931 13th Street, NW, Washington, DC 20009-4432, Tel: (202) 483-6622, Fax: (202) 483-1135; (202) 483-1127.

More below the flip…

USCA 2007 is the nation’s largest AIDS conference.  USCA 2007 is covering all areas of HIV/AIDS related topics such as Treatment and Research, Housing, Nutrition, Prevention, Public Policy, Building Healthy Organizations, Care and Primary Care, and other special issues.  USCA 2007 has over 150 exhibitors and has attracted over 4,000 attendees working in all areas of the HIV/AIDS Epidemic.  USCA 2007 highlights the risk of HIV/AIDS in the Native American community.

“Too many people, for a long time, have (believed) that this is a gay man’s disease,” said Clayton Barbour, Medical Director of the Desert AIDS Project’s (DAP) Wells Fargo HIV Health Center.  DAP provides medical care and comprehensive support services to people living with HIV/AIDS in the Coachella Valley.  Free, anonymous HIV testing is available, as well as counseling, home health services, legal assistance, and assistance with housing, medications, food, re-employment, and more.  Prevention and education outreach is available to any group.  As a fundraiser, DAP operates 5 thrift stores including Revivals in Cathedral City, Palm Springs, Palm Desert and Desert Hot Springs.  To make a donation, volunteer, or for more info on DAP call 760-323-2118.

USCA 2007 Program Partners include:

• AIDS Action
• The AIDS Institute
• AIDS Alliance for Children, Youth and Families
• AIDS Medicine and Miracles
• American Academy of HIV Medicine
• Association of Nurses in AIDS Care
• Association of Nutrition Services Agencies
• The Balm in Gilead
• CAEAR Foundation
• Camp Heartland
• Elton John AIDS Foundation
• LIFEbeat
• Mothers’ Voices – United to End AIDS
• The NAMES Project Foundation
• National AIDS Housing Coalition
• National Alliance of State and Territorial AIDS Directors
• National Association of People with AIDS
• National Native American AIDS Prevention Center