Welcome to the John Does I-V v.
UnitedHealthcare Insurance Company Settlement website
Not only United Healthcare Insurance Company, but also several other companies including OptumRX Inc., Pacificare Life and Health Insurance Company, UHC of California d/b/a United Healthcare of California, and UnitedHealth Group are also affected by the proposed class action settlement. If you are registered in or enclosed by any health plan offered or administered by United and have been given HIV/AIDS specialty medications, then you are eligible to file a claim against Health Insurance Company.
If you submit your claim form for their valid out-of-pocket costs before deadline, then you are eligible to get compensation from the company. The amount of money that you will obtain for the repayment of payments you completed will be pro-rated, if the total amount of the claim exceeds $240,000 - HOW TO Get COMPENSATION:
The public advocacy group sued on behalf of several "John Doe" plaintiffs last year to stop United from forcing HIV/AIDS patients to purchase their "specialty medications" from its subsidiary OptumRx Inc. or pay "thousands of dollars or more each month" at their local retail pharmacy.
The suit alleged the policy is discriminatory because United does not enforce a similar requirement on patients who purchase non-specialty medications.
Last year, Consumer Watchdog settled a similar lawsuit against Anthem Blue Cross of California. According to a May 15, 2013, settlement, Anthem agreed to give HIV/AIDS patients the unconditional right to opt-out its mail-order service at any time. Doe v. Blue Cross of Cal. et al., No. 37-2013-00031442-CU-CR-CTL, settlement reached (Cal. Super. Ct., San Diego County May 15, 2013).
Doe v. United Healthcare Insurance Co. et al., No. 13-864, proposed settlement reached (C.D. Cal., S. Div. Mar. 19, 2014).
The policy also is discriminatory because it forces HIV/AIDS patients to forgo talking in person to pharmacists who know their medical histories and are "best positioned to detect potentially life-threatening adverse drug interactions and dangerous side effects," according to the complaint.
Patient privacy is also threatened under the policy because HIV/AIDS specialty medications often are delivered in refrigerated containers, which may lead neighbors and co-workers to suspect that the patient is seriously ill, according to the complaint.
The proposed settlement, which still must be approved by the court, will allow HIV/AIDS patients who have privacy or delivery concerns to obtain their medications from an in-network retail pharmacy.
UnitedHealthcare HIV/AIDS Mail-Order Drug Class Action Settlement
By Anne Bucher
May 28, 2014
UnitedHealthcare Insurance Company, OptumRX Inc., Pacificare Life and Health Insurance Company, UHC of California d/b/a UnitedHealthcare of California and UnitedHealth Group ("United") have agreed to settle a class action lawsuit with a group of patients who have been prescribed HIV/AIDS specialty treatments. If you are enrolled in or covered by any health plan offered or administered by United and have been prescribed HIV/AIDS specialty medications, your rights may be affected by the proposed class action settlement.
The United class action lawsuit alleged that United's requirement that members obtain their HIV/AIDS medications on an in-network basis from the Special Pharmacy by mail violated state and federal statutes, regulations and rights of privacy, including ERISA, the Americans with Disabilities Act, and the California Unruh Act.
Due to the complexity of the drug regimen, patients diagnosed with HIV or AIDS rely on local pharmacists who are able to monitor them for adverse side effects and potentially life-threatening drug interactions. HIV/AIDS patients and their loved ones often rely on these pharmacists to help them cope with the challenges of living with the condition. Patients have also expressed privacy concerns associated with the mail-order prescriptions.
United has denied any wrongdoing but has agreed to settle the class action lawsuit to avoid the expense and uncertainty of ongoing litigation. Under the terms of the United HIV settlement, United will allow patients with HIV or AIDS to opt out of a requirement that they obtain their medications by mail order. Class Members who paid more for their prescriptions as a result of the mail-order requirement may also seek reimbursement for their out-of-pocket costs.
Class Members of the United HIV class action settlement include all natural persons who have been diagnosed as having HIV or AIDS and who, as of March 19, 2014, are enrolled in or covered by any health plan offered or administered by United or its affiliates that includes a prescription drug benefit (including but not limited to insured and self-funded ERISA plans, individual plans, governmental plans, and church or group plans), are prescribed HIV/AIDS specialty medications and are required to participate in the program.
Under the terms of the United HIV class action settlement, United has agreed to change its policy to allow patients with HIV or AIDS to opt out of a requirement that they obtain their medications by mail order.
United has also agreed to reimburse Class Members who submit Claim Forms for their valid out-of-pocket costs. If the total amount of valid out-of-pocket costs exceed $240,000, then the amount of reimbursement paid to each Class Member shall be reduced by a pro rata basis.
Proof of Purchase
None required. However, Class Members seeking compensation for out-of-pocket costs must submit receipts or any other records of payment supporting their claims, including but not limited to credit card payment records or evidence of payments made to a pharmacist, along with their Claim Form.
CLICK HERE TO FILE A CLAIM
Claim Form Deadline
John Does 1-5 v. UnitedHealthcare Insurance Company, et al., Case No.
8:13-cv-00864-DOC-JPR, in the U.S. District Court for the Central District of California, Southern Division
Highlights of United HIV Mail-Order Drug Settlement:
Case Name: John Does 1-5 v. UnitedHealthcare Insurance Company, et al., Case No. 8:13-cv-00864-DOC-JPR, in the U.S. District Court for the Central District of California, Southern Division
Doe v. United Settlement Administrator
P.O. Box 43263
Providence, RI 02940-3263
· Submit claim form: November 14, 2014
· Exclusion Requests: June 23, 2014
· Submit Objections: Before June 23, 2014
· Court hearing: Scheduled for July 14, 2014, 8:30 a.m.
Peter R. Bisio
HOGAN LOVELL US LLP
Edith M. Callas
WHATLEY KALLAS LLP