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Author Topic: Humana, Cigna, And Others Caught Trying To Price Poz Customers Out  (Read 1159 times)

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Offline tednlou2

  • Member
  • Posts: 5,731
Glad it was investigated.

"Humana health insurance company has been fined $500,000 by Florida regulators for failing to cooperate with investigators looking into claims that its drug pricing discriminated against people living with HIV.

The Florida Office of Insurance Regulation (FIOR) announced the fine last week following an investigation into allegations that Humana and three other health insurers in Florida -- Cigna, Preferred Medical and CoventryOne -- structured their prescription drug policies to discourage people living with HIV from selecting their insurance plans.

The number of new HIV cases in Florida jumped 23% in the first six months of 2015. All six of the state's major metropolitan areas are on the U.S. Census Department's 2014 list of the top 25 cities with high HIV rates, with Miami sitting in first place.

The complaint, lodged by the AIDS Institute and the National Health Law Program (NHeLP), alleged that the insurers placed all HIV drugs, including generics, on their highest (tier five) pricing schedule -- which in Humana's case required a 50% co-pay after a $1,500 deductible.
Discriminatory drug pricing would directly violate provisions of the Patient Protection and Affordable Care Act (Obama Care) and federal civil rights laws.

The FIOR said that Humana didn't make its documents "freely available" to investigators looking into these allegations as required by Florida law.

"The FOIR regulatory action sends a strong message that health insurers will be held accountable. Rigorous compliance monitoring and enforcement is essential to ensuring that the Affordable Care Act fulfills its promise of protecting patients against discrimination and providing affordable healthcare," stated Wayne Turner, NHeLP staff attorney.

In the consent order issued by the state insurance commissioner, which ended the investigation into Humana's HIV drug pricing, Humana denied that its practices were discriminatory or violated the law, but agreed to pay the fine and "to maintain procedures to ensure that it does not by effect or design treat those living with HIV/AIDS less favorably than any other condition."

In the order Humana also agreed to establish an independent program -- not associated with its litigation department -- that would investigate and examine its market conduct.

In 2014, Humana entered into an agreement with the FIOR to lower 2015 federal marketplace plan co-pays on HIV medications from 50% to 10%. For medications costing less than $600, a $50 flat copayment fee would be charged.

While the pricing agreement and fine are a victory for Floridian's living with HIV, an AIDS Institute report has found that Florida insurance providers' discriminatory practices aren't limited to HIV medications.

A study of Florida's 2016 qualified health plans found that nearly all coverage of hepatitis B and C drugs by several insurers is subject to high co-insurance levels. Humana places most Hepatitis C drugs on tier 5, which translates into coinsurance of either 40% or 50% of drug cost, after the patient pays a $3,800 deductible. Aetna and CoventryOne place all hepatitis C drugs and almost all hepatitis B drugs on tiers 4 and 5, which carry coinsurance of 40% and 50% of drug cost, after a $2,750 deductible.


Offline Wade

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  • Member
  • Posts: 2,306
Re: Humana, Cigna, And Others Caught Trying To Price Poz Customers Out
« Reply #1 on: February 24, 2016, 09:40:43 AM »
No surprise to me Ted, I lived there many years.
Take a look at Florida's governor ..

HIV 101 - Basics
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 You can read more about PEP and PrEP here
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Offline mecch

  • Member
  • Posts: 13,168
  • red pill? or blue pill?
Re: Humana, Cigna, And Others Caught Trying To Price Poz Customers Out
« Reply #2 on: February 24, 2016, 09:54:52 AM »
Same old depressing greed and puritanical hate.

Insurance companies' purpose is to make money. 


People judge HIV+ people as degenerate STD carriers who got what they deserve and are now too expensive and should just die as fast and cheaply as possible.

Oh, plus, it's a gay plague.  We hate the gays.


Switzerland has insurance companies, not single payer.  They can't get away with this shit (much more regulations than USA) but I can "feel" in the last few years they are fed up with the expense of drugs such as the Hep C and HIV drugs and their clients who need them.  My company has been trying little things to annoy me and cut their payouts.  It's true, I'm damned expensive for them, they are "forced" to pay out on me, can't dump me, and I'm healthy so it's going to be a long long long payout.
« Last Edit: February 24, 2016, 09:59:02 AM by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline bmancanfly

  • Member
  • Posts: 726
  • Medicare For All !
Re: Humana, Cigna, And Others Caught Trying To Price Poz Customers Out
« Reply #3 on: February 24, 2016, 11:30:58 AM »
Humana's 2015 revenue $54 billion.

Fined $500 thousand.  That'll show 'em.   
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell


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