Senate passes Ujifusa bill to protect
patients’ pharmacy options
White bagging refers to a practice where insurers require patients to get their prescriptions from insurer-affiliated pharmacies that are often mail order-only. The bill (2023-S 0870) would prohibit this practice.
Traditionally, if a patient needs a clinician-administered medication, such as a chemotherapy drug, the patient goes to the hospital where the clinician orders the needed drug from the on-site pharmacy and administers the medication.
According to the American Hospital Association, white bagging causes multiple problems. The practice is not sensitive to necessary changes in patient care plans. A health care provider often decides the patient needs a different dosage or a different drug after reviewing a patient’s labs or measurements on the day of treatment. Even though the hospital has these medications on site at their own pharmacy, they must wait for the drug to arrive from the specialty pharmacy or not get reimbursed. In addition, once filled and labeled, expensive specialty drugs cannot be substituted or modified. If the care plan is changed, often the drugs must be discarded.
Senator Ujifusa’s bill would prohibit insurers or pharmacy benefit managers (PBMs) from engaging in white bagging practices. It would ensure patients could choose which pharmacy they want to obtain their medications from and ensure in-network providers (like hospitals) would get paid for providing services, regardless of which pharmacy they obtained the medications from.
Three states (Louisiana, Minnesota and Vermont) currently have legislation prohibiting white bagging and nine other states are considering legislation to join them.
“White bagging saves middlemen money, but creates waste, barriers to care and disruptions to the patient-provider relationship,” said Senator Ujifusa (D-Dist. 11, Portsmouth, Bristol). “Across the country, state legislators are looking to audit and rein in insurers and their PBMs. This bill shows Rhode Island is prepared to join the movement to restrain vertically integrated middlemen conglomerates from making money by limiting provider care for patients.”
The bill now heads to the House for consideration.
