BCBS North Carolina accused of discriminatory drug pricing by HIV advocacy groups

Two HIV advocacy groups allege Blue Cross Blue Shield of North Carolina is violating antidiscrimination requirements by pricing HIV drugs in high cost-sharing tiers. 

The HIV+Hepatitis Policy Institute and the North Carolina AIDS Action Network filed complaints with the HHS civil rights department and the North Carolina insurance department Dec. 8. In the complaints, the organizations claim BCBS North Carolina places most drugs for HIV treatment, including generics, in higher formulary tiers, which mean higher cost-sharing rates for patients. 

Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, said in a press release that the ACA's non-discrimination provisions are clear that placing all drugs for one condition on a high-cost tier is "presumptively discriminatory." 

"This is a clear effort to dissuade people living with and at risk of HIV from enrolling in these plans and jeopardizes people's health and the public health since enrollees would be forced to pay huge sums of money just to access their life-saving HIV drugs," Mr. Schmid said. 

A spokesperson for BCBS North Carolina said the payer has not received a formal complaint from either group. 

"Blue Cross and Blue Shield of North Carolina is working to make sure our members have affordable access to the care they need," the spokesperson told Becker's. "We have not received a formal complaint from either of these entities, and we will respond accordingly upon receipt."

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