HPC Recommends Rules on White-bagging, Brown-bagging

Last week, HPC staff presented recommendations for a legislatively mandated report on insurer-compelled “brown-bagging” and “white-bagging” of pharmaceuticals that is forthcoming later this month. 
Brown-bagging refers to the dispensing of a medication from a pharmacy (typically a specialty pharmacy) directly to a patient, who then transports the medication to the physician’s office for administration. White-bagging is the distribution of patient‐specific medication from a pharmacy, typically a specialty pharmacy, to the physician’s office, hospital, or clinic for administration.
The Health Policy Commission recommended, due to a number of patient safety concerns that MHA and its member hospitals have drawn attention to, that: 
1. Payers should not require brown-bagging for any drug;
2. Payers should offer home infusion as an optional benefit, not as a requirement;
3. Payers that require white-bagging should ensure minimum safety standards and capabilities in the third-party specialty pharmacies with which they contract;
4. Payers that require white-bagging should offer site neutral payment;
5. Lawmakers should take action to increase public transparency and public oversight for the full drug distribution chain; and 
6. The Group Insurance Commission, the Massachusetts Health Connector, MassHealth and all other state payers should require all plans with which they contract to adopt best practice provisions.