CVS Health is investigating a potential glitch in its drug pricing system that appears to have charged women copayments for prescription birth control – though the scope of the error is unclear.
The problem came to the attention of Rep. Jackie Speier, D-Calif., after one of her staffers attempted to buy generic prescription birth control in Washington D.C. and was charged a $20 copay.
The retailer’s error, highlighted in a letter to the company from Speier, runs counter to a provision of the federal health law that mandates insurance coverage of women’s preventive care – a category including generic prescription birth control – without cost sharing.
Speier’s office said it also has received similar complaints both from women in D.C. and in her California district. In these cases, the customers may have been covered by different insurance plans, but a coding error appeared to have accidentally attached the cost-sharing to the purchases, Speier’s office said. They added that the issue could have affected retailers other than CVS, but that it is still too early to tell who has been charged or where.
CVS did not comment on what may have caused the copays to be charged or how many people they may have affected. But the charges add up — women often shell out between $10 and $35 per month in copays for birth control pills. Under health law rules, insurers are allowed to charge copays for non-generic birth control pills but should not be charging them for generic versions.
In an email, spokeswoman Christine Cramer said the company is looking into the issue and will “address [Speier’s] concerns as quickly as possible,” adding that CVS is “committed to ensuring our business practices comply with all applicable laws and regulations.”
Judy Waxman, vice president for health and reproductive rights at the Washington, D.C.–based National Women’s Law Center, said the CVS case is certainly not an aberration. The implementation of no-copay birth control has already seen glitches, she added.
“There have been various problems along the way, like everything else with the bill,” she said. “But we’re working on trying to figure out what they are, and we just don’t have it at this point.”
Another open question related to this particular issue is how women who paid the copayments might get refunds.
Leila Abolfazli, NWLC senior counsel, said getting the matter fixed was relatively simple. She called her insurance company, which in turn contacted CVS. To receive a refund, she had to show her receipt the next time she went to the pharmacy. But what’s unclear, she said, “is whether it is a person-by-person fix,” or whether CVS can process refunds in one keystroke.
This question is important, advocates say, because if it is the former, women who do not realize they shouldn’t be charged a copayment could fall through the cracks. They won’t know to push for the fix or to get the refund owed to them.