05.29.2017

SENATE OKs LONG-SOUGHT STUDY ON INSURER “BAGGING”

The Massachusetts Senate wrapped up its deliberation on more than 1,000 proposed amendments to its FY2018 budget proposal  on Thursday night. The state’s budget process now moves to a conference committee where select members of the House and Senate will negotiate to bring their two budget documents into line.

As healthcare is a major component of the state’s economy, issues of interest to the hospital community appear throughout the legislature’s budgets. Among several amendments the Senate approved was an  MHA-endorsed amendment that calls on the Health Policy Commission to study and issue a report on quality and safety concerns related to the emerging health insurance industry practice of requiring the “brown-bagging” and “white-bagging” of cancer and chronic-illness-related pharmaceuticals. Sen. John Keenan (D-Quincy) was the lead champion on the amendment.

Brown bagging is when insurers require cancer and chronic disease patients to obtain certain injected or infused medications through a specialty pharmacy. In many cases, these medications are no longer covered by insurance companies unless the patient self-administers the medication; uses a visiting nurse; or brings the drug to their healthcare facility or physician’s office to be administered by a clinician. “White bagging” is where insurers require medications to be dispensed by a specialty pharmacy and delivered to a hospital, infusion center, pharmacy or physician’s office for administration to a specific patient.  In addition to patient safety concerns, both practices pose troublesome legal predicaments with the state’s prohibition on the re-dispensing of pharmaceuticals.