Health: Pharmacies, Disabilities, and Discrimination

 The Story:

A controversy over the interpretation of the Rehabilitation Act of 1973 has now come before the US Supreme Court. Although the subject seems abstruse, the view the Justices take of it could have a lot to do with the affordability (or otherwise) of prescriptions for disabled people throughout the country.


The Rehabilitation Act prohibited discrimination on the basis of disability by any program or activity receiving federal funds. The ACA (Obamacare) incorporates that Act, and allows people who believe they have been the victims of such discrimination to challenge the terms and conditions of benefit plans.

The case before the Supreme Court this term is CVS Pharmacy v. Doe. The action has been brought by many HIV-positive people (“Doe”) who have health insurance coverage through their employers. These plans involve the use of CVS to administer their prescription-drug benefits. CVS refers to certain drugs necessary to HIV-positive people as “specialty medicines,” and its rule as to such medicines is that covered persons may receive in-network prices for them if they either accept them by mail or pick them up at CVS pharmacies. If they pick them up at any other pharmacy, they must pay out-of-network prices.

In Pill Form:

The rules in question were surely designed to leverage CVS’ position as a plan administration into an advantage for the same store as the manager of a retail chain. The issue, though, is whether patients who are thereby denied what the circuit court called “medically appropriate dispensing of their medications” are the victims of discrimination on the basis of their disability.

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