Patients should expect that any drugs or medications they require are safe, administered effectively and available when needed. But, some commercial health insurance companies are changing the rules about how drugs are handled and administered, with serious consequences for patient care.

Under new policies being implemented by a number of large commercial insurance companies, providers can no longer acquire and store a variety of drugs needed to treat their patients. Instead, they are forced to use a third-party specialty pharmacy – often owned by the same parent company as the insurer – to dispense the drug, a practice known as “white bagging.”

Relying on third-party specialty pharmacies to deliver treatments on a patient-by-patient basis can result in delays in treatment, receipt of improper treatment doses and the inability of a provider to adjust drug dosages based on the patient’s same-day diagnostics. This practice also hamstrings providers’ ability to foresee and mitigate drug shortages.

For example, white bagging can pose a special threat to cancer patients, whose infusion regimens may change on a daily basis. Not having the new infusion regimen immediately available at the hospital can cause delays in treatment, potentially adversely affecting cancer patients’ recovery.

This week we released a report outlining the issue in more detail and why the insurers’ policies simply serve to drive more revenue to health insurers through their pharmacy benefit management and specialty pharmacy lines of business.

We’re calling on regulators to prohibit health insurers from preventing providers from directly acquiring and storing drugs used in patient care.

Unfortunately, white bagging is just one of many mechanisms insurers are using to usurp clinical decision-making power from providers and carve out additional profit streams, often providing little-to-no notice to providers that these policies are being implemented. 

We’re pushing back forcefully on these efforts.

  • We’ve urged the Centers for Medicare & Medicaid Services and Federal Trade Commission to protect hospitals and patients from certain unfair, anticompetitive practices.
  • We continue to inject new research and papers into the policy arena, including an analysis highlighting how commercial health insurance practices contribute to burnout in the clinical workforce and make it more difficult for some Americans to access the care they need. The report highlights the adverse impact of the rise in prior authorization and inappropriate reimbursement delays and denials.
  • And, we’re sharing the stories about the real impact on patients with the media.

There’s more to come. Visit our new Health Plan Accountability webpage for more details and resources.

We’ll continue to make the case that these commercial health plan abuses must be addressed to protect patients’ health and ensure that medical professionals, not the insurance industry, are making the key decisions in patient care.

Related News Articles

Headline
The Colorado Hospital Association today named Maryjane Wurth its interim president and CEO. Wurth, who was AHA’s executive vice president and chief operating…
Headline
The Centers for Disease Control and Prevention early Friday morning opted for a broad endorsement of Pfizer COVID-19 vaccine booster shots, issuing interim…
Perspective
The optimism of early summer that we were turning the corner on COVID-19 has been replaced with hard reality. The pandemic will be with us for the foreseeable…
Headline
The Centers for Medicare & Medicaid Services Friday released a final rule with additional policies for health insurance issuers and the Health…
Chairperson's File
News coverage continues to show that many hospitals have been stretched beyond capacity during the COVID-19 pandemic. Each wave has brought incredible pressure…
Headline
Percy Allen II, past president of the National Association of Health Services Executives, died Sept. 12 at age 80. Among other leadership positions, he…