An inquiry by California Democratic Congresswoman Jackie Speier has found that CVS illegally charged 11,000 women a co-pay for contraceptives.
Rep. Speier sent letters to the CEOs of CVS Health and Walgreens this month calling for them to correct a coding error that led to the illegal charges, and to provide remedies to women who had been unjustly charged.
Sol J. Ross, head of federal affairs at CVS Health, wrote Speier that refund checks will be issued to those affected and should all be received by October 1.
Ross wrote that CVS was “very concerned to hear that the care and service we provided fell far short of expectations” and that there were inappropriate charges made.
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Customers with questions about an illegal co-pay charge are also encouraged to call 1-800-704-6589 and ask to speak with a Tier 2 representative or supervisor so that their issue will be heard by a more senior staff member with override capabilities.
The Affordable Care Act requires coverage of preventive women’s health services, including contraception, with no cost-sharing under federal law. But Speier said she feared many women don’t know their rights under the law, and would either be charged unnecessarily or even go without birth control entirely if they couldn’t afford the co-pay.
A recent study from the Guttmacher Institute found that a drastically higher percentage of women (67 percent in spring of 2014) were able to get contraceptive pills with no cost-sharing than were able to before the Affordable Care Act was passed (15 percent in the fall of 2012).
The coverage gap, the report says, is due to exceptions in the law. Insurers can charge co-pays for brand name drugs with generic equivalents, for instance, or if a woman uses an out-of-network provider. Certain religious employers are also exempt from providing contraceptive coverage on their health plans.
But some of that gap can also be explained by health plans charging co-pays where they shouldn’t, and by administrative snafus in pharmacies like this one.