STATE OF NEW YORK

OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
Mark T. Bertolini
Chairman, Chief Executive Officer and President
Aetna Inc.
151 Farmington Avenue
Hartford, CT 06156

Re: Mail-Order "Specialty" Pharmacies

Dear Mr. Bertolini:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State, including Aetna Inc. members.
Recently, the New York State Attorney General negotiated with Empire Blue Cross Blue
Shield to encourage them to implement Empire`s new "Specialty Prescription Drug
Fulfillment Hardship Exception Criteria" that permit qualifying members to obtain
specialty drug prescriptions at retail pharmacies. Policies like this can help ensure access
to critical medicines for consumers, which is why our office is encouraging Aetna Inc. to
implement a similar policy, if such a policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether Aetna Inc. has a mail-order
exception policy in place, and if so, please provide a copy of your policy to our office. If

Mark T. Bertolini
June 3, 2013
Page 2


Aetna Inc. does not have such a policy, please advise whether and when it plans to
implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
Mark Pearson
Chairman and Chief Executive Officer
AXA Equitable Life Insurance Company
1290 Avenue of the Americas
New York, NY 10104

Re: Mail-Order "Specialty" Pharmacies

Dear Mr. Pearson:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State, including AXA Equitable Life
Insurance Company members. Recently, the New York State Attorney General
negotiated with Empire Blue Cross Blue Shield to encourage them to implement
Empire`s new "Specialty Prescription Drug Fulfillment Hardship Exception Criteria" that
permit qualifying members to obtain specialty drug prescriptions at retail pharmacies.
Policies like this can help ensure access to critical medicines for consumers, which is
why our office is encouraging AXA Equitable Life Insurance Company to implement a
similar policy, if such a policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether AXA Equitable Life
Insurance Company has a mail-order exception policy in place, and if so, please provide a
Mark Pearson
June 3, 2013
Page 2



copy of your policy to our office. If AXA Equitable Life Insurance Company does not
have such a policy, please advise whether and when it plans to implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
John D. Bennett, MD
President and Chief Executive Officer
CDPHP
500 Patroon Creek Blvd.
Albany, New York 12206-1057

Re: Mail-Order "Specialty" Pharmacies

Dear Mr. Bennett, MD:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State, including CDPHP members.
Recently, the New York State Attorney General negotiated with Empire Blue Cross Blue
Shield to encourage them to implement Empire`s new "Specialty Prescription Drug
Fulfillment Hardship Exception Criteria" that permit qualifying members to obtain
specialty drug prescriptions at retail pharmacies. Policies like this can help ensure access
to critical medicines for consumers, which is why our office is encouraging CDPHP to
implement a similar policy, if such a policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether CDPHP has a mail-order exception
policy in place, and if so, please provide a copy of your policy to our office. If CDPHP

John D. Bennett, MD
June 3, 2013
Page 2


does not have such a policy, please advise whether and when it plans to implement such a
policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
David Cordani
President and Chief Executive Officer
Cigna Corporation
900 Cottage Grove Road
Bloomfield, CT 06002

Re: Mail-Order "Specialty" Pharmacies

Dear Mr. Cordani:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State, including Cigna Corporation
members. Recently, the New York State Attorney General negotiated with Empire Blue
Cross Blue Shield to encourage them to implement Empire`s new "Specialty Prescription
Drug Fulfillment Hardship Exception Criteria" that permit qualifying members to obtain
specialty drug prescriptions at retail pharmacies. Policies like this can help ensure access
to critical medicines for consumers, which is why our office is encouraging Cigna
Corporation to implement a similar policy, if such a policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether Cigna Corporation has a mail-order
exception policy in place, and if so, please provide a copy of your policy to our office. If

David Cordani
June 3, 2013
Page 2


Cigna Corporation does not have such a policy, please advise whether and when it plans
to implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
Frank J. Branchini
President and Chief Operating Officer
EmblemHealth, Inc.
55 Water Street
New York, NY 10041

Re: Mail-Order "Specialty" Pharmacies

Dear Mr. Branchini:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State, including EmblemHealth, Inc.
members. Recently, the New York State Attorney General negotiated with Empire Blue
Cross Blue Shield to encourage them to implement Empire`s new "Specialty Prescription
Drug Fulfillment Hardship Exception Criteria" that permit qualifying members to obtain
specialty drug prescriptions at retail pharmacies. Policies like this can help ensure access
to critical medicines for consumers, which is why our office is encouraging
EmblemHealth, Inc. to implement a similar policy, if such a policy is not already in
place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.



Frank J. Branchini
June 3, 2013
Page 2


Please advise by June 17, 2013 as to whether EmblemHealth, Inc. has a mail-order
exception policy in place, and if so, please provide a copy of your policy to our office. If
EmblemHealth, Inc. does not have such a policy, please advise whether and when it plans
to implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
Christopher C. Booth
Chief Executive Officer
Excellus BlueCross BlueShield
P.O. Box 22999
Rochester, NY 14692

Re: Mail-Order "Specialty" Pharmacies

Dear Mr. Booth:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State, including Excellus BlueCross
BlueShield members. Recently, the New York State Attorney General negotiated with
Empire Blue Cross Blue Shield to encourage them to implement Empire`s new "Specialty
Prescription Drug Fulfillment Hardship Exception Criteria" that permit qualifying
members to obtain specialty drug prescriptions at retail pharmacies. Policies like this can
help ensure access to critical medicines for consumers, which is why our office is
encouraging Excellus BlueCross BlueShield to implement a similar policy, if such a
policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether Excellus BlueCross BlueShield has
a mail-order exception policy in place, and if so, please provide a copy of your policy to
Christopher C. Booth
June 3, 2013
Page 2


our office. If Excellus BlueCross BlueShield does not have such a policy, please advise
whether and when it plans to implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
Rev. Patrick J. Frawley
President and Chief Executive Officer
Fidelis Care New York
95-25 Queens Boulevard, 8th Floor
Rego Park, NY 11374

Re: Mail-Order "Specialty" Pharmacies

Dear Mr. Frawley:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State. Recently, the New York State
Attorney General negotiated with Empire Blue Cross Blue Shield to encourage them to
implement Empire`s new "Specialty Prescription Drug Fulfillment Hardship Exception
Criteria" that permit qualifying members to obtain specialty drug prescriptions at retail
pharmacies. Policies like this can help ensure access to critical medicines for consumers,
which is why our office is encouraging Fidelis Care New York to implement a similar
policy, if such a policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether Fidelis Care New York has a mail-
order exception policy in place, and if so, please provide a copy of your policy to our

Rev. Patrick J. Frawley
June 3, 2013
Page 2


office. If Fidelis Care New York does not have such a policy, please advise whether and
when it plans to implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
Pat Wang
President and Chief Executive Officer
Healthfirst
100 Church Street
New York, NY 10007

Re: Mail-Order "Specialty" Pharmacies

Dear Ms. Wang:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State. Recently, the New York State
Attorney General negotiated with Empire Blue Cross Blue Shield to encourage them to
implement Empire`s new "Specialty Prescription Drug Fulfillment Hardship Exception
Criteria" that permit qualifying members to obtain specialty drug prescriptions at retail
pharmacies. Policies like this can help ensure access to critical medicines for consumers,
which is why our office is encouraging Healthfirst to implement a similar policy, if such
a policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether Healthfirst has a mail-order
exception policy in place, and if so, please provide a copy of your policy to our office. If

Pat Wang
June 3, 2013
Page 2


Healthfirst does not have such a policy, please advise whether and when it plans to
implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
Alphonso O`Neil-White
Chief Executive Officer, President and Director
HealthNow New York Inc.
257 West Gennesee Street
Buffalo, New York 14202

Re: Mail-Order "Specialty" Pharmacies

Dear Mr. O`Neil-White:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State. Recently, the New York State
Attorney General negotiated with Empire Blue Cross Blue Shield to encourage them to
implement Empire`s new "Specialty Prescription Drug Fulfillment Hardship Exception
Criteria" that permit qualifying members to obtain specialty drug prescriptions at retail
pharmacies. Policies like this can help ensure access to critical medicines for consumers,
which is why our office is encouraging HealthNow New York Inc. to implement a similar
policy, if such a policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether HealthNow New York Inc. has a
mail-order exception policy in place, and if so, please provide a copy of your policy to

Alphonso O`Neil-White
June 3, 2013
Page 2


our office. If HealthNow New York Inc. does not have such a policy, please advise
whether and when it plans to implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
Michael W. Cropp, M.D.
President and Chief Executive Officer
Independent Health
511 Farber Lakes Drive
Buffalo, New York 14221

Re: Mail-Order "Specialty" Pharmacies

Dear Mr. Cropp, M.D.:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State, including Independent Health
members. Recently, the New York State Attorney General negotiated with Empire Blue
Cross Blue Shield to encourage them to implement Empire`s new "Specialty Prescription
Drug Fulfillment Hardship Exception Criteria" that permit qualifying members to obtain
specialty drug prescriptions at retail pharmacies. Policies like this can help ensure access
to critical medicines for consumers, which is why our office is encouraging Independent
Health to implement a similar policy, if such a policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether Independent Health has a mail-order
exception policy in place, and if so, please provide a copy of your policy to our office. If

Michael W. Cropp, M.D.
June 3, 2013
Page 2


Independent Health does not have such a policy, please advise whether and when it plans
to implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
Denise V. Gonick
President and Chief Executive Officer
MVP Health Care
625 State Street, PO Box 2207
Schenectady, NY 12301-2207

Re: Mail-Order "Specialty" Pharmacies

Dear Ms. Gonick:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State, including MVP Health Care
members. Recently, the New York State Attorney General negotiated with Empire Blue
Cross Blue Shield to encourage them to implement Empire`s new "Specialty Prescription
Drug Fulfillment Hardship Exception Criteria" that permit qualifying members to obtain
specialty drug prescriptions at retail pharmacies. Policies like this can help ensure access
to critical medicines for consumers, which is why our office is encouraging MVP Health
Care to implement a similar policy, if such a policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether MVP Health Care has a mail-order
exception policy in place, and if so, please provide a copy of your policy to our office. If

Denise V. Gonick
June 3, 2013
Page 2


MVP Health Care does not have such a policy, please advise whether and when it plans
to implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
Robert E. Broatch
Executive Vice President and Chief Financial Officer
The Guardian Life Insurance Company of America
7 Hanover Square
New York, NY 10004

Re: Mail-Order "Specialty" Pharmacies

Dear Mr. Broatch:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State. Recently, the New York State
Attorney General negotiated with Empire Blue Cross Blue Shield to encourage them to
implement Empire`s new "Specialty Prescription Drug Fulfillment Hardship Exception
Criteria" that permit qualifying members to obtain specialty drug prescriptions at retail
pharmacies. Policies like this can help ensure access to critical medicines for consumers,
which is why our office is encouraging The Guardian Life Insurance Company of
America to implement a similar policy, if such a policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether The Guardian Life Insurance
Company of America has a mail-order exception policy in place, and if so, please provide
a copy of your policy to our office. If The Guardian Life Insurance Company of America
Robert E. Broatch
June 3, 2013
Page 2



does not have such a policy, please advise whether and when it plans to implement such a
policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
Thomas McGuire, Esq.
Senior Deputy General Counsel
UnitedHealthCare of New York, INC. and
UnitedHealthCare Insurance Company of New York
CT030-15NA
450 Columbus Boulevard
Hartford, CT 06103
Re: Mail-Order "Specialty" Pharmacies

Dear Mr. McGuire, Esq.:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State, including United Health Care
and Oxford members. Recently, the New York State Attorney General negotiated with
Empire Blue Cross Blue Shield to encourage them to implement Empire`s new "Specialty
Prescription Drug Fulfillment Hardship Exception Criteria" that permit qualifying
members to obtain specialty drug prescriptions at retail pharmacies. Policies like this can
help ensure access to critical medicines for consumers, which is why our office is
encouraging United Health Care and Oxford to implement a similar policy, if such a
policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.


Thomas McGuire, Esq.
June 3, 2013
Page 2


Please advise by June 17, 2013 as to whether United Health Care and Oxford has
a mail-order exception policy in place, and if so, please provide a copy of your policy to
our office. If United Health Care and Oxford does not have such a policy, please advise
whether and when it plans to implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General
STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL
120 BROADWAY, NEW YORK, NEW YORK 10271

ERIC T. SCHNEIDERMAN DOROTHEA CALDWELL-BROWN
Attorney General Assistant Attorney General Assistant Attorney General
Division of Social Justice
Health Care Bureau
Vox: (212) 416-6346
Fax: (212) 416-8034

June 3, 2013

VI A FI RST CL ASS MAI L
John Cannon
Interim President and Chief Executive Officer
WellPoint, Inc.
120 Monument Circle
Indianapolis, IN 46204

Re: Mail-Order "Specialty" Pharmacies

Dear Mr. Cannon:

The New York State Attorney General's Office has received dozens of
complaints relating to health insurance company policies that require plan members to
purchase certain drugs from mail-order and specialty pharmacies. Those complaints have
come from health care consumers across New York State. Recently, the New York State
Attorney General negotiated with Empire Blue Cross Blue Shield to encourage them to
implement Empire`s new "Specialty Prescription Drug Fulfillment Hardship Exception
Criteria" that permit qualifying members to obtain specialty drug prescriptions at retail
pharmacies. Policies like this can help ensure access to critical medicines for consumers,
which is why our office is encouraging WellPoint, Inc. to implement a similar policy, if
such a policy is not already in place.

The complaints received in the New York State Attorney General's Health Care
Bureau from New York consumers raise a range of very serious concerns about health
plan blanket requirements to obtain prescription drugs through the mail. For some
consumers, packages that arrive through mail-order compromise their privacy, resulting
in curiosity by family members regarding the nature of the consumer's medical condition.
Where drugs require refrigeration, home delivery may interfere with consumers' work
schedule or result in spoilage of the specialized medicines. Finally, where dosage is in
flux, mail delivery of what may not be the current dosage presents serious health
challenges. These are just a few real examples of undeniable hardships wrought by the
imposition of inflexible policies requiring mail-order prescriptions.

Please advise by June 17, 2013 as to whether WellPoint, Inc. has a mail-order
exception policy in place, and if so, please provide a copy of your policy to our office. If


June 3, 2013
Page 2



WellPoint, Inc. does not have such a policy, please advise whether and when it plans to
implement such a policy.

If you have any questions regarding this matter, please contact me at the number
listed above. Your prompt cooperation is appreciated.



Very truly yours



Dorothea Caldwell-Brown
Assistant Attorney General

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