{"id":31609,"date":"2022-02-16T10:20:07","date_gmt":"2022-02-16T16:20:07","guid":{"rendered":"http:\/\/update.legislature.ne.gov\/?p=31609"},"modified":"2022-02-18T16:06:45","modified_gmt":"2022-02-18T22:06:45","slug":"insurance-coverage-for-clinician-administered-drugs-sought","status":"publish","type":"post","link":"https:\/\/update.legislature.ne.gov\/?p=31609","title":{"rendered":"Insurance coverage for clinician-administered drugs sought"},"content":{"rendered":"

The Banking, Commerce and Insurance Committee heard testimony Feb. 15 on a bill that would prohibit health insurance coverage restrictions on medication that is administered by a clinician.<\/p>\n

\"Sen.
Sen. Eliot Bostar<\/figcaption><\/figure>\n

The bill defines such drugs as outpatient prescription medications that a patient cannot administer themselves and requires the assistance of a health care provider in a clinical setting.<\/p>\n

LB943, introduced by Sen. Eliot Bostar of Lincoln, would prohibit most health insurance policies in Nebraska from:
\n\u2022 refusing to cover clinician-administered medication and related services;
\n\u2022 imposing coverage and benefit limitations or charging a higher premium or copay for clinician-administered medication;
\n\u2022 interfering with a patient obtaining clinician-administered medication;
\n\u2022 requiring clinician-administered medication to be dispensed by a pharmacy chosen by the insurer or reimbursing the insured at a lower rate; or
\n\u2022 limiting or excluding coverage of a clinician-administered medication when such medication would otherwise be covered.<\/p>\n

Policies that cover a specific illness and employee self-funded benefit plans would be excluded from the bill\u2019s provisions.<\/p>\n

Bostar said insurers currently can require patients to purchase prescription medication from a contracted specialty pharmacy\u00a0\u2014 a practice he called \u201cwhite bagging.\u201d The practice limits patient choice and has led to negative health outcomes, Bostar said.<\/p>\n

\u201cWhite bagging has caused delays in patients getting their medications and has even resulted in hospitals being sent the wrong dose or the wrong medication,\u201d he said.<\/p>\n

Lori Murante of the Nebraska Medical Center testified in support of LB943. Federal law requires medicine to be tracked, she said, but white bagging complicates that process, burdening hospitals and causing delays in patients receiving prescriptions.<\/p>\n

\u201cWhite bagging allows insurers rather than health care providers to mandate where, when and how drugs are purchased, prepared and administered,\u201d Murante said.<\/p>\n

Elizabeth Boals-Shively of Henderson Health Care Services also spoke in support. She said white bagging has caused pharmacies to send an incorrect medicine or the wrong dosage of a correct medicine to her hospital.<\/p>\n

\u201cLB943 means that patients can receive their injections and infusions when and where it is most accessible,\u201d Boals-Shively said.<\/p>\n

David Root of pharmacy benefit manager Prime Therapeutics testified against LB943. He said the bill is anti-competitive and would cause patients to pay more.<\/p>\n

\u201cThese drugs are incredibly expensive,\u201d Root said. \u201cThe idea that we as PBMs are simple going to waste that product is, frankly, insane.\u201d<\/p>\n

Also in opposition was Jeremiah Blake of Blue Cross and Blue Shield of Nebraska. White bagging is used sparingly and helps control costs and keeps premiums low, he said.<\/p>\n

\u201cFrom the patient\u2019s perspective, these tools are a safe and effective way to get the same medication, administered by a health care provider with the same therapeutic outcome, at a lower cost,\u201d Blake said.<\/p>\n

The committee took no immediate action on LB943.<\/p>\n","protected":false},"excerpt":{"rendered":"

The Banking, Commerce and Insurance Committee heard testimony Feb. 15 on a bill that would prohibit health insurance coverage restrictions on medication that is administered by a clinician.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"colormag_page_container_layout":"default_layout","colormag_page_sidebar_layout":"default_layout","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[6],"tags":[264],"class_list":["post-31609","post","type-post","status-publish","format-standard","hentry","category-banking-commerce-and-insurance","tag-sen-eliot-bostar"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts\/31609","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=31609"}],"version-history":[{"count":4,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts\/31609\/revisions"}],"predecessor-version":[{"id":31690,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts\/31609\/revisions\/31690"}],"wp:attachment":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31609"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31609"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31609"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}