About Us
Doe v. CVS Pharmacy, Inc.
No. 20-1374,
982 F.3d 1204 (9th Cir. 2020),
cert. granted, 2021 WL 2742790 (U.S. July 2, 2021).
You have the power to change the lives of seniors in poverty
1 in 3 older adults struggle to meet their basic needs. Your gift can help seniors secure good jobs, get the benefits they've earned, and stay connected to their communities.
On November 12, 2021 the Court dismissed this case, following the parties joint stipulation to dismiss the writ of certiorari.
Issue: Whether Section 504 of the Rehabilitation Act of 1973 — and by extension Section 1557 of the Patient Protection and Affordable Care Act, which incorporates the “enforcement mechanisms” of other federal antidiscrimination statutes — provides a disparate-impact cause of action for plaintiffs alleging disability discrimination.
In the midst of efforts in both the legislative and executive branches to address rising prescription drug prices, the Supreme Court has taken up a case regarding discrimination in access to and pricing for prescription drugs to treat people with disabilities.
This case involves a class of HIV-positive participants in an employer-offered prescription drug benefit plan. The plan’s pharmacy benefit manager (PBM), the company that administered the program, was CVS Pharmacy, Inc. (CVS). CVS considered specialty medications “in network” only when beneficiaries obtained them from CVS retail locations or through mail delivery. Doe v. CVS Pharm., Inc., 348 F. Supp. 3d 967, 977 (N.D. Cal. 2018). Purchasing medications out-of-network subjected participants to higher, often prohibitive, costs. The participants wished to purchase their prescription medications from pharmacists of their choice, i.e., pharmacists who knew their medical histories and could provide relevant advice. Id.
In 2018, the class sued their employers, CVS, and prescription drug providers, alleging that the policies of the pharmacy benefit program have a disproportionate negative impact on them because of their status as HIV-positive—a disability—and that the network restrictions denied them meaningful access to their prescription drug benefits. Doe, 982 F.3d at 1211-12 (9th Cir. 2020). They brought claims under the Rehabilitation Act (Section 504), the Affordable Care Act’s anti-discrimination provision (Section 1557), the Americans with Disabilities Act (ADA), and California’s Unruh Civil Rights Act. Id.
In December 2018, the federal district court for the Northern District of California dismissed all the enrollees’ claims. Doe v. CVS Pharm., Inc., 348 F. Supp. 3d 967, 986 (N.D. Cal. 2018). The district court held that the plaintiffs did not show that enrollees with HIV/AIDS are disparately impacted by the programs’ restrictions relative to other enrollees, as all enrollees were subject to the higher “out-of-network” costs, and that any disproportionate impact did not deny HIV/AIDS-positive enrollees meaningful access to program benefits. Id. at 982, 986–87. The district court’s ruling was then appealed to the U.S. Court of Appeals for the Ninth Circuit.