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Aetna Sues Watchdog Groups That Sued It Over HIV Drugs

By Gregory A. Freeman  
   June 04, 2018

The insurance giant is suing a consumer group and law firm that called it to task for inadvertently revealing the HIV status of customers. Aetna says it was their fault.

In what has become a comedy of errors, Aetna is suing the nonprofit Consumer Watchdog, which tangled with the insurer for trying to require mail order purchase of HIV drugs and for accidentally disclosing the HIV positive status of thousands of its members.

The insurer says it actually is their fault that it used a window pane envelope that revealed the recipient's HIV status.

Aetna filed suit against  Consumer Watchdog and Whatley Kallas LLP, a consumer law firm, which were responsible for suing Aetna after it used a window pane envelope that revealed members' HIV status. Aetna says the defendants should pay $20 million in damages for the settlements and fines Aetna has been forced to pay so far, as well as additional civil penalties from ongoing federal and state investigations.

The law firms currently represent a consumer whose HIV status was publicly disclosed through the window pane envelope. This John Doe was one of several plaintiffs who Consumer Watchdog and Whatley Kallas LLP represented in a 2014 lawsuit challenging Aetna's prior practice that mandated its HIV patients obtain their life-sustaining prescription medicines by mail order, rather than by going to their local pharmacy.

This is how the situation unfolded:

  • The plaintiffs contended the mail order policy exposed HIV patients' health status to their families, friends, neighbors and coworkers, a violation of state and federal privacy laws.
  • They also contended the mail order program  threatened HIV patients' health by cutting off access to community pharmacists who provide essential advice and counseling.
  • Aetna settled the lawsuit by permanently stopping the mail order system and reimbursing patients who paid higher prices by choosing to go to local pharmacies.
  • Aetna mailed a required notice of the settlement to its 11,875 affected members, advising them of their rights under the settlement. Aetna sent the letter out in an envelope with a large window that showed the first line of the letter, including the words, “when filling prescriptions for HIV medications.”
  • Aetna settled a class action suit related to the privacy breach in federal court in Pennsylvania and also agreed to new privacy practices with the State of New York.
  • Aetna filed this latest lawsuit, claiming that the settlement administrator sought approval only from Whatley Kallas when specifying what type of envelope would be used, that Aetna did not sign off on the proposed envelope.

 "Aetna's attempt to blame us is a frivolous waste of judicial resources and Aetna knows it," said Harvey Rosenfield of Consumer Watchdog. "We had no control over the mailing process and had no idea that Aetna decided to use an envelope with a giant window that exposed the recipient's HIV status."

Gregory A. Freeman is a contributing writer for HealthLeaders.


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