UPDATE: Publix to begin covering HIV preventative drug PrEP for employees

By : Jeremy Williams
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UPDATE:

After meeting with state Rep. Carlos Guillermo Smith, Publix announced they would begin allowing PrEP to be covered for their employees under their prescription benefits.

The company took to Twitter saying:

Publix appreciates the concerns shared by our associates and customers. We offer generous health coverage to our eligible full-time and part-time associates at an affordable premium and are committed to the health and well-being of our associates and their families.

Publix regularly evaluates what is covered by our health plan and have made the decision to expand our health plan’s coverage of Truvada to include Pre-exposure Prophylaxis (PrEP). We are working with our pharmacy benefits manager to implement this change as quickly as possible.

ORIGINAL STORY:

Publix has come under fire after claims from employees that they are being refused coverage for the HIV preventative drug Truvada, more commonly referred to as PrEP, under the company’s prescription benefit plan.

According to the website The Body, a Publix employee attempted to obtain the pre-exposure prophylaxis (PrEP) drug from the Atlanta-based Fulton County PrEP Clinic but had his claim denied.

“We’ve started 255 people on PrEP at our clinic alone, and this is the only person that we weren’t able to get PrEP for,” David Holland, director of the Fulton County PrEP Clinic, said speaking with The Body.

The employee, who was not identified in the article, appealed the insurance company’s decision twice, coverage for the drug was denied in both appeals.

This is not the first time the Lakeland-based supermarket chain has drawn criticism for refusing to cover the HIV-preventative drug. HIV blogger and activist Josh Robbins addressed the issue in 2016, posting employee denial letters from Publix.

Robbins tweeted, “Alert: @Publix should be ASHAMED denying employees coverage for FDA-approved #HIV prevention drug PrEP. Activists RT plz! CONFIRMED!”

Concerns that Publix, one of Florida’s largest employers with nearly 800 locations in the state, is not covering PrEP drew the attention of state Rep. Carlos Guillermo Smith.

“I have spoken directly with the government affairs team at Publix and obtained the statement below,” Smith wrote on his Facebook page. “I am VERY concerned by their shortsighted decision to risk the health of their employees by denying them CDC recommended medication. If you are a Publix shopper, YOU should stop by your local store and express your concern to management as well!”

In the post, Smith shared the statement he received from Publix.

It reads: “Publix offers very generous health coverage to our eligible full-time and part-time associates and their family members at an affordable premium. The plan’s definition of medical necessity applies to all covered benefits. Under this definition, coverage is provided for the identification, treatment or management of a medical condition. Coverage is not generally provided to diagnose a medical condition for which a member has no indications or to treat a medical condition that a member might get in the future. The plan does provide coverage for preventive care benefits such as annual physicals, age-appropriate health screenings and vaccines. Currently, our plan covers Truvada for members who are being treated for active HIV infections or who have been recently exposed to HIV. In cases where Truvada is being used prophylactically, the plan’s definition of medical necessity was not met. As the largest employee-owned company in the country, Publix has long been recognized as an organization dedicated to our associates. We appreciate hearing from our customers and associates and will re-evaluate coverage for Truvada as a preventive benefit.”

Publix’s response led many on social media to speculate that the decision not to cover PrEP had to do with moral objection since HIV remains a disease that disproportionately affects gay and bisexual men; however it is unknown if the employee who was seeking PrEP is a member of the LGBTQ community.

Publix has yet to respond to Watermark’s request for comment.

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