September 22, 2014
WASHINGTON, DC – Congresswomen Jackie Speier (D-San Francisco/San Mateo Counties) received a letter today from Sol J. Ross, Head of Federal Affairs of CVS Health, in response to her September 9th letter to CEO Larry J. Merlo calling on CVS Health to correct an error and provide remedies to consumers who have been charged an illegal co-pay for generic contraceptives at CVS pharmacies.
Ross’s letter indicated that this drug price coding error has affected approximately 11,000 women. CVS Health is actively sending reimbursement checks to its customers who should expect to receive them by October 1, 2014 at the latest.
“Since the release of the letter I sent to CVS Health CEO Larry Merlo on September 9th, my office has received a number of complaints from women throughout my Congressional District and around the country” Congresswoman Speier said. “I am encouraged that CVS is identifying those who have been impacted by this error and will provide them with reimbursements. In addition, CVS must make sure its pharmacists know the core tenets of the Affordable Care Act to provide effective and legal customer service. I still urge individuals to contact my office who have been charged an illegal co-pay.”
CVS Health indicated that although the coding error will be fixed by September 26, 2014, CVS pharmacists have also been empowered to escalate and get errors fixed immediately on site if any future coding errors do occur. Customers with questions about an illegal co-pay charge, or those who want to make sure they are receiving a reimbursement and whose prescription drug benefits are covered through the Pharmacy Benefit Manager (PBM) CVS Caremark, are encouraged to call 1-800-704-6589 and ask to speak with a Tier 2 representative or supervisor about a generic birth control illegal co-pay charge to make sure that their call is immediately escalated to a staff member with override capabilities.
Congresswoman Speier is also recommending other companies that she received complaints about, such as Walgreens and Target, although they were not the Pharmacy Benefit Manager (PBM) in these cases, provide training to their retail pharmacists to know and apply the basic principles of the Affordable Care Act so that they can help identify and rectify these illegal co-pay charges for customers who frequent their stores.
The ACA’s “Women’s Health Amendment,” or section 2713 of the Public Health Service Act, requires coverage of women’s health preventive services, including contraception, without cost sharing. The Women’s Health Amendment was put in place so that women could no longer be discriminated against for being women when accessing health insurance coverage.
As Ranking Member of the House Oversight and Government Reform Committee’s Subcommittee on Energy Policy, Health Care, and Entitlements Subcommittee, Congresswoman Speier had requested follow up information from Merlo, including what CVS Health was doing to proactively educate their retail pharmacists to identify illegal co-pay charges when they arise and assist customers in reversing the error.