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New bill aims to stop insurance practice of ‘white bagging'

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Medicine White Bagging

EAU CLAIRE (WQOW) - When someone is diagnosed with a chronic illness, there's a lot of worry that can come with it.  Where will they get the best care?  How serious is their condition?  Can they continue with work?

A new bill set to hit the Wisconsin legislature is trying to take away a few worries by putting a stop to an insurance process called 'white bagging.'

32-year-old Koreen Holmes found out she had breast cancer in January when she was 35 weeks pregnant with her second child.

Every three weeks, she receives immunotherapy from Prevea Cancer Center at HSHS Sacred Heart Hospital in Eau Claire.

"It came as a total surprise. It came out of the blue. It was put on us in the middle of the year. I was already going through treatment and everything," Koreen said.

But because of a practice called white bagging, her health insurance company put a new policy in place mandating where the hospital obtained her medication, so she had a hard time getting her immunotherapy treatment.

"It's something that I physically need and to know that the possibility of not being able to get that, it was scary. Literally cancer comes down to life or death," Holmes said.

This nearly derailed her treatment, so on top of fighting cancer, she was fighting her insurance company.

"We talked about the the possibility of filing for bankruptcy. There was talk about me having to go somewhere else, which was also scary because again, I've been in treatment since January. I already had my established team. They became family to me," Koreen said.

White bagging is a tactic by health insurers that requires certain medications to be purchased through specialty pharmacies, usually ones owned by the insurance company, instead of the patient's preferred local health care provider.

But lawmakers on both sides of the aisle in Wisconsin, including Rep. Jesse James, are aiming to put a stop to the practice by co-sponsoring 'Koreen's Law.'

"When you have rheumatoid arthritis, when you have multiple sclerosis, these diseases don't pick whether you're a Democrat or a Republican. It impacts human beings," Rep. James. said.

Director of Oncology at Prevea Cancer Center Angela Quick said if a patient's dosage of their meds needs to be adjusted at a moment's notice, the hospital can normally do that since they order their drugs in bulk, but white bagging causes a roadblock.

"When you are mandated to have the drugs ordered from a specialty pharmacy, those come very specific to the patient in this very specific dose and they're not tracked and traced and so it doesn't follow the quality guidelines that we use in the hospital," Quick said.

If the drugs came from a specialty pharmacy, that very specific dose was probably ordered a week ago, and they'd have to order a different one.

The new medicine would still need to be shipped to the hospital's pharmacy, delaying when it can actually be given to the patient.

"It basically is treatment delay.  That's the biggest safety issue," Quick said. "Also, the specialty pharmacies charge those patients for those drugs on the day that they're ordered.  And so they would have already paid for the drugs that we aren't going to be using, and then they'll have to pay again for the second dose-adjusted drug."

Quick said white bagging disrupts care for patients of not just cancer, but several conditions.

Koreen's Law is in its early stages and is looking for more co-sponsorship until Monday.

Officials said a hearing for the bill may happen in November.

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