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Cigna agrees to lower drug costs for Florida HIV patients in Obamacare plans

 
Published Nov. 7, 2014

TALLAHASSEE — One of the four Florida insurers accused of overcharging HIV and AIDS patients for their medications has agreed to take steps to reduce those costs, the Florida Office of Insurance Regulation announced Friday.

Cigna is the first of the four insurers to agree to change how it handles HIV medications. The insurer admitted to no wrong-doing in an agreement with state regulators but said it was making the changes partly to avoid litigation.

Florida officials began investigating after two advocacy groups — the AIDS Institute based on Davis Islands in Tampa and the National Health Law Program — filed a federal complaint alleging four insurance companies had discriminated against HIV and AIDS patients.

The insurers named in the complaint were Cigna, Humana, Coventry Health Care and Preferred Medical.

The complaint found that the insurers' "silver" plans sold through the Affordable Care Act exchange in Florida are designed so that routine medications for HIV/AIDS patients come with the greatest out-of-pocket costs.

Cigna, for instance, puts all HIV drugs, brand name and generic, in the highest "specialty drug" tier, requiring patients to pay 40 percent of costs once they meet their deductibles, the complaint says.

Now, Cigna has agreed to move all the generic HIV medications into the "generic" tier, reducing what enrollees should have to pay. For 2015, Cigna has also agreed to cap each enrollee's cost-sharing for four HIV drugs to $200 per month.

Some of the most popular HIV medications cost $2,400 to $2,948 for a 30-day supply. Most HIV patients take multiple drugs.

"I appreciate Cigna taking proactive steps to address these allegations," Florida Insurance Commissioner Kevin McCarty said in a statement. "I am committed to making sure insurers are not acting in a manner that is discriminatory and inconsistent with Florida law and today's announcement shows Cigna is committed to those principles as well."

McCarty's office would not say whether agreements with the other three insurers are also in the works.

Contact Jodie Tillman at jtillman@tampabay.com or (813) 226.3374. Follow @jtillmantimes.