West Cleveland News

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

Pharmacy Times reports that during 2023, legislative efforts in over 20 states have been launched to restrict white-bagging and brown-bagging policies within the healthcare industry. This highlights an ongoing legislative battle between health insurers and healthcare providers, including hospitals, as they vie for financial dominance.

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

In the same press release, Manning voiced her concerns over these insurance practices. She emphasized their cost-effectiveness for the company while overlooking patient needs. She pointed out that such practices could lead to treatment delays as patients must wait until the healthcare practice receives the drug. This delay could last days or even weeks due to delivery issues, damage, or administrative hurdles on the insurer's end.

Manning stressed in her press release the importance of avoiding delays in critical drug access for Ohioans. She argued that patient health should take precedence over insurance company profits, stating: "We don't want Ohioans waiting on essential drugs so that insurance companies can prioritize their financial gains."

Manning's legislation aims to counter restrictive insurance practices according to her press release. It prohibits providers from mandating physician-administered drugs exclusively from affiliated pharmacies and prevents higher cost-sharing for drugs dispensed outside these 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.