LOS
ANGELES, April 19, 2024 /PRNewswire/ -- Late
yesterday the United States
District Court for the Northern
California ruled that CVS acted intentionally under the
"deliberate indifference" standard when it implemented a drug
program that discriminates against people living with HIV.
Download the Order here.
The latest ruling comes in a long-running legal battle over
civil rights violations relating to a CVS drug program
that limits people living with HIV to obtaining their
life-saving medications only by mail. The lawsuit
alleges that the program cuts off access to
knowledgeable pharmacists and other critical benefits and services
essential for people living with HIV.
The four HIV-positive "John Doe" Plaintiffs in the case are
represented by lawyers for the non-profit Consumer Watchdog and
Whatley Kallas, LLP.
In the Order issued last night, Chief Judge for the Northern
District of California Edward M. Chen ruled that CVS was on notice
that Plaintiffs' civil rights were threatened and that they may
seek money damages and an injunction to change CVS's practices.
CVS, one of the largest healthcare companies in the world, owns
pharmacies throughout the U.S., but also operates as a pharmacy
benefit manager, which coordinates pharmacy benefits for people
like the John Does who are enrolled in employer-provided health
plans.
Judge Chen also ruled last night that CVS's arguments that its
employer clients, not CVS, controlled the prescription drug
benefits provided to their employees were ineffective to inoculate
CVS from the legal claims.
According to the Order:
"… Plaintiffs sufficiently allege that Defendants
implemented The Program by "utiliz[ing] its discretion" under its
contracts with employers and 'offer[ing] financial inducements to
plan sponsors.' 'As such, CVS effectively controls and directs
the pharmacy benefits of such plans. Furthermore...CVS Caremark has
an ongoing ability to alter plan terms and the prescription drug
benefits provided thereunder to Class Members.' CVS also
reserves the right to alter pharmacy benefits at any time. These
facts sufficiently allege that the Defendants have
control over The Program."
Download the Third Amended Complaint here.
Under civil rights laws incorporated into the federal Affordable
Care Act, "intentional discrimination may be established by a
showing of 'deliberate indifference.'" Duvall v. Cnty. Of
Kitsap, 260 F.3d 1124, 1139 (9th Cir. 2001). To show
"deliberate indifference," a plaintiff must establish the
defendant's "[1] knowledge that a harm to a federally protected
right is substantially likely, and [2] a failure to act upon that
likelihood." Id.
In addition to money damages, the lawsuit seeks a nation-wide
injunction to bar CVS from continuing to implement the mandatory
mail delivery program for HIV medications.
The Ninth Circuit Court of Appeals previously held that
Plaintiffs "adequately alleged that they were denied
meaningful access to their prescription drug benefit, including
medically appropriate dispensing of their medications and access to
necessary counseling." Doe v. CVS Pharmacy, Inc., 982
F.3d 1204, 1211 (9th Cir. 2020). The Supreme Court granted
certiorari, but Defendants withdrew their petition under pressure
from disabilities rights groups. CVS Pharmacy, Inc. v.
Doe, 210 L. Ed. 2d 990, 141 S. Ct. 2882, 2883 (2021).
Most other major health insurance companies in the U.S. now
allow members to opt out of mail-order-only delivery of HIV
medications because of numerous settlements achieved by attorneys
for Consumer Watchdog and Whatley
Kallas, LLP.
If you are prescribed medications to treat or prevent HIV and
are enrolled in a healthcare plan where your pharmacy benefits are
coordinated by CVS, or if you are interested in more information
about this lawsuit, please contact Consumer Watchdog
here and let us know about your experience.
The case is John Doe One,
et al. v. CVS, et al., No.: 3:18-cv-01031 and is pending in
federal district court in San
Francisco.
Consumer Watchdog is a non-profit and non-partisan public
interest organization. Visit us on the web
at https://www.consumerwatchdog.org/.
Whatley Kallas, LLP attorneys
have earned a national reputation—based on trust, respect,
demonstrated commitment and tangible results—in connection with
their representation of healthcare providers and members of the
organized medicine community. Visit Whatley Kallas, LLP on the
web here: https://www.whatleykallas.com/.
View original content to download
multimedia:https://www.prnewswire.com/news-releases/federal-court-rules-cvs-acted-with-deliberate-indifference-when-it-adopted-rx-program-that-discriminates-against-people-living-with-hiv-says-consumer-watchdog-302122423.html
SOURCE Consumer Watchdog