West Cleveland News

State Representative Gayle Manning (R- North Ridgeville) has introduced a bill that seeks to prevent insurance companies from insisting on the purchase of physician-administered drugs through an insurer's specialty pharmacy before being delivered to a healthcare provider.

According to a press release from Manning, "white-bagging" insurance practices occur when an insurance company requires specific medications to be purchased from the insurer's preferred specialty pharmacy. These medications are then transported by a commercial carrier to the healthcare provider for treatment.

An article from Pharmacy Times reveals that in 2023, legislative efforts have been launched in over 20 states to curb white-bagging and brown-bagging policies within the healthcare industry. This trend underscores an ongoing legislative struggle between health insurers and healthcare providers, including hospitals, as they vie for financial dominance.

Manning voiced her concerns about these insurance practices in her press release. She emphasized their cost-effectiveness for the company while overlooking patient needs. She noted that such practices could lead to treatment delays, necessitating patients to wait until the healthcare practice receives the drug. This waiting period might span days or even weeks due to delivery issues, damage, or administrative hurdles on the insurer's end.

In her press release, Manning underscored the importance of avoiding delays in critical drug access for Ohioans. She urged prioritizing patient health over insurance company profits and stated, "We don't want Ohioans waiting on essential drugs so that insurance companies can prioritize their financial gains."

According to Manning's press release, her legislation aims to counter restrictive insurance practices by prohibiting providers from mandating physician-administered drugs exclusively from affiliated pharmacies. It also prevents higher cost-sharing for drugs dispensed outside pharmacies. The bill includes patient safeguards, allowing collaboration with specific pharmacies for compounding or special clinical conditions. House Bill 156 is currently awaiting additional hearings in the House Insurance Committee with a focus on patient protection and flexibility.