Humana Agrees to Consent Order Regarding HIV/AIDS Medications and Conduct of Exams
TALLAHASSEE, Fla. –
Florida Insurance Commissioner Kevin McCarty has issued a Consent
Order to Humana Medical Plan, Inc., (Humana), which specifically
addresses issues related to the Office of Insurance Regulation’s (Office)
target market conduct examination of the company for its drug formulary and the
requirement to make company records freely available to examiners. In the
Consent Order, Humana denies any allegation that its classification of drugs
was unfairly discriminatory or that its plan violated the law.
Order approved earlier in the week and related to the Aetna Inc.
acquisition of Humana resolves this issue going forward, but is dependent upon
the completion of the entire acquisition. In the meantime, or in case the
acquisition does not close, the Office has reached this additional agreement
with Humana regarding the treatment of HIV/AIDS medications and the cooperation
required during examinations.
Consent Order completes an exercise that began in 2014 when the Office was made
aware of allegations that Humana and several other companies may have been
violating Florida’s HIV/AIDS anti-discrimination law. The Office
conducted a market conduct examination targeted at the classification of
HIV/AIDS medications on the Humana formulary. Florida law requires
companies, their officers, employees and attorneys to make books and records
“freely available” to examiners. Having all records screened by lawyers
and only produced in a litigation-style manner is not making these
records “freely available.” This Consent Order closes the
examination and requires Humana to pay a penalty in the amount of $500,000 and
to comply with Florida Statutes and the Florida Administrative Code with
respect to examinations.
Key aspects of the Consent
Order include agreements that:
will continue maintaining procedures to ensure that it does not treat
those living with HIV/AIDS less favorably than any other condition.
- Humana will
cooperate with the Office’s market conduct examinations and investigations
going forward and acknowledging that these are not civil actions.
- Humana will
establish an independent market conduct examination and investigation
compliance program separate from its litigation department by July 1, 2016.