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Ninth Circuit Reverses Dismissal of HIV/AIDS Prescription Drug Claim Under ACA Disability Discrimination Rule
Thomson Reuters Practical Law Link to more items from this source
Dec. 16, 2020

"The US Court of Appeals for the Ninth Circuit has held that plan participants requiring specialty medications for treatment of HIV/AIDS stated a claim for disability discrimination under Section 1557 of the [ACA]. The participants alleged that a pharmacy benefit manager's (PBM's) policy required them to obtain specialty medications through its designated specialty pharmacy for those medications to be considered in-network benefits available at a lower price." [Doe v. CVS Pharmacy, Inc., No. 19-15074 (9th Cir. Dec. 9, 2020)]

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