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Louisiana White-Bagging Law: A Stepping Stone for Other States

June 7, 2021

In late 2020, CSRO fought an expansive new mandatory white-bagging policy being implemented by Blue Cross Blue Shield of Tennessee. The policy, which required drugs administered in rheumatologists’ offices to be ordered and delivered through Blue Cross’s preferred Specialty Pharmacy, alarmed CSRO and rheumatologists in Tennessee.

CSRO argued extensively that the new policy mandating the use of a white-bagging drug acquisition model would fail to achieve intended savings, increase administrative hassle and mistakes, and potentially impede patient access to important therapies.

Buy-and-bill has long been under assault by payers, but the white-bagging mandate in Tennessee was one of the most sweeping to date. Rheumatologists across the country have looked at the situation in Tennessee as a sign of what may happen across the country.

However, the rheumatology community is not without recourse in this battle. Where payers have forged ahead with these policies despite the collective concerns raised by providers engaging in buy-and-bill, some advocates and practitioners have acted to head off white-bagging before it is mandated in their state.

Louisiana, with the encouragement and support of CSRO, is the most recent success in this fight, and Governor John Bell Edwards recently signed SB 191 into law. The bill prevents payers regulated by the state from mandating the use of white-bagging. The law effectively pre-empted large scale white bagging mandates by payers in the state, and the rheumatology community can look to it as a stepping stone to build on in other states.

SB 191 is a first step in the process of combatting the use of broad white-bagging mandates by payers across the country, and CSRO will monitor SB 191’s effectiveness to see if the model will need refinement for other states looking to tackle the issue. 


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