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CA Department of Insurance

Insurance Commissioner applauds Court decision to suspend Anthems requirement that its HIV/AIDS patients only use a mail order pharmacy

News: 2013 Press Release

For Release: May 23, 2013
Media Calls Only: 916-492-3566
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Insurance Commissioner applauds Court decision to suspend Anthem's requirement that its HIV/AIDS patients only use a mail order pharmacy
Under settlement agreement, policyholders may opt out of mail order program

SACRAMENTO-Insurance Commissioner Dave Jones applauded today's court-approved settlement between Anthem Blue Cross and Consumer Watchdog regarding how policyholders receiving treatment for HIV/AIDS purchase their medications.

"Today's court decision, which eliminates the requirement that Anthem policyholders receiving treatment for HIV/AIDS only use a mail order pharmacy for their medication is another important win for consumer protection in California," said Jones. "Pharmacists are an extension of a patient's treatment team, providing medication expertise and consultation that a mail order pharmacy may not be able to offer. Patients should not have to rely on an off-site vendor call center when they need assistance with medication management."

"The decision also ensures patients are able to maintain their relationship with a qualified pharmacist, who is essential in protecting their health information privacy rights," Jones continued. "Decisions regarding medication management and a patient's treatment regimen should be made by a patient's treatment team and be driven by what is best for the patient-the court-approved settlement ensures additional protection for Anthem's policyholders by allowing them to choose the option that is most appropriate in managing their care, whether that is the mail order program or through a pharmacist."

The class action suit was filed by Consumer Watchdog in response to complaints received from policyholders, HIV/AIDS advocates and pharmacists. The Department of Insurance also received complaints, opened its own investigation of those complaints, and reviewed the settlement agreement to ensure consumer protections were appropriately addressed. The Department of Insurance will monitor compliance with the settlement agreement and court decision.


The California Department of Insurance, established in 1868, is the largest consumer protection agency in California. Insurers collect $310 billion in premiums annually in California. Since 2011 the California Department of Insurance received more than 1,000,000 calls from consumers and helped recover over $469 million in claims and premiums. Please visit the Department of Insurance website at Non-media inquiries should be directed to the Consumer Hotline at 800.927.4357. Telecommunications Devices for the Deaf (TDD), please dial 800.482.4833.

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