CVS Pharmacy The complaintalleges the program violates the Affordable Care Act and federallaws that safeguard HIV/AIDS patients' health and privacy. (Photo:Shutterstock)

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National health care law firm WhatleyKallas is teaming up withConsumer Watchdog to bring lawsuits over mandatory mail-order drug programs that allegedlydiscriminate against HIV/AIDS patients.

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Earlier this month, Edith Kallas and Alan Mansfield ofWhatleyKallas and the nonprofit consumer advocacy group sued CVS Health in the U.S. District Court forthe Northern District of California on behalf of four anonymousplaintiffs. The suit, which seeks class action certification,claims that the pharmacy giant's insurance plan violates plaintiffs' privacy by forcing them tobuy their HIV/AIDS medication at retail CVS stores or have themmailed to their home. A nearly identical suit was filed the same dayin California's Central District trial court.

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“This program threatens HIV/AIDS patients' health and privacy,”according to the complaint. “If HIV/AIDS patients in [healthplans where CVS Caremark controls pharmacy benefits] do not obtain their HIV/AIDSmedications from [Caremark California Specialty Pharmacy], thenthey must either pay more out-of-pocket or pay full price with noinsurance benefits whatsoever—thousands of dollars or more eachmonth—to purchase their medications at an in-network communitypharmacy where they can receive counseling from a pharmacist andother services they may need to stay alive.”

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Related: Privacy concerns in Amazon and Aetna-CVS healthdeals

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A spokesman for CVS described the allegations as “bothfactually and legally incorrect.”

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“Our highest priority is assuring patient access to clinicallyappropriate drugs while managing overall health care costs for ourclients, and we offer our clients multiple clinical tools andpharmacy network options targeted at achieving both of thesegoals,” according to an email from the spokesman. ”Thisincludes an option for clients to allow their members with HIV tofill their HIV-related medications at in-network local independentpharmacies and other national chain retail pharmacies.”

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The complaint alleges the program violates the Affordable CareAct and federal laws that safeguard HIV/AIDS patients' health andprivacy. In addition to class certification, it seeks damages and acourt order preventing CVS from continuing the mandatory mail-orderprogram.

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In the last few years, WhatleyKallas and Consumer Watchdog have gone afterhealth insurers—including United Healthcare Insurance Co.,Anthem Insurance Cos. Inc., Cigna and Aetna Inc.—for the samepractice. All of the suits have settled, with at least twocompanies, United and Anthem, agreeing to allow patients to opt outof the mail-order program.

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Ironically, the settlement with Aetna recently resulted inanother wave of breach of privacy lawsuits against the healthinsurer after notices relating to the settlement were mailed lastsummer in envelopes with glassine windows that revealed thousands of HIVpatients' names and conditions. A $17 million payment to settle claims filed in federal court inPhiladelphia currently is awaiting judicial approval.

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Kallas, Mansfield and Consumer Watchdog are representing a JohnDoe plaintiff against Aetna in a suit stemming from the improperdisclosure in U.S. district court in Northern California.

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CVS has until mid-March to respond to the suits.

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Earlier this month, the U.S. Department of Justice asked CVS andAetna for more information on CVS Health's bid to buy theConnecticut-based health insurer under the antitrustHart-Scott-Rodino Act, according to a federalSEC filing.

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This story has been updated to include comment from a CVSspokesman.

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