LOS ANGELES, CA – California patient advocacy organizations Healthy African American Families, Familia Unida, and For Grace today sent a letter to California Attorney General Jerry Brown requesting an investigation into discriminatory practices by health insurance companies that deny entire California communities access to critical and often life-saving medications.
The full text of the letter read:
Dear Attorney General Brown,
We are writing to ask that your office investigate an unscrupulous health insurer practice that denies California patients in pain access to critical medication. We are concerned that this insurer practice particularly discriminates against African American and Latino families, those living with disabilities, and women, especially those in low-income communities.
California insurers, including Blue Shield, refuse to initially cover doctor-prescribed and FDA-approved treatments. Some insurers require that patients fail on up to five medicines before they can have access to the one the doctor initially prescribed.
The result of this practice is that members of minority and low-income communities are denied access to new and better medications, and that they experience prolonged pain and often deteriorating health.
When health insurers deny patients access to timely and effective treatment, those who need medicine for chronic pain – including Californians suffering from arthritis, multiple sclerosis, fibromyalgia and diabetic peripheral neuropathy (a painful diabetes-related nerve condition) – are especially hurt. It is not only unethical, but cruel, for insurers to deny a patient access to a medicine the doctor knows will relieve their pain and to require the patient to go through multiple steps of taking drugs that don’t work.
Denying patients in pain access to medication is more than a quality-of-life issue. When a single mother suffering from fibromyalgia is forced to try multiple pain treatments that do not work, she often must miss work, and arrange childcare and travel, which threatens her livelihood and ability to provide for her family.
In March of 2009, 16 state Attorneys General sent a letter to the Centers for Medicare and Medicaid Services (CMS) raising concerns about Medicare plans requiring patients to fail first on multiple medicines, including treatments not even approved for their particular condition. In response, CMS tightened restrictions and adopted a policy that prevents health insurers from requiring patients to take more than two medicines before the insurer will cover the medicine that the doctor thinks is the most appropriate treatment.
California patients not covered by Medicare deserve the same protections. We respectfully request your office investigate California health plan practices relating to their fail first policies so patients in pain can have access to the treatments their individual physician thinks they need.
Healthy African American Families 2