The Massachusetts Senate wrapped up its deliberation on more than 1,000 proposed amendments to its FY2018 budget proposal  on Thursday night. The state’s budget process now moves to a conference committee where select members of the House and Senate will negotiate to bring their two budget documents into line.

As healthcare is a major component of the state’s economy, issues of interest to the hospital community appear throughout the legislature’s budgets. Among several amendments the Senate approved was an  MHA-endorsed amendment that calls on the Health Policy Commission to study and issue a report on quality and safety concerns related to the emerging health insurance industry practice of requiring the “brown-bagging” and “white-bagging” of cancer and chronic-illness-related pharmaceuticals. Sen. John Keenan (D-Quincy) was the lead champion on the amendment.

Brown bagging is when insurers require cancer and chronic disease patients to obtain certain injected or infused medications through a specialty pharmacy. In many cases, these medications are no longer covered by insurance companies unless the patient self-administers the medication; uses a visiting nurse; or brings the drug to their healthcare facility or physician’s office to be administered by a clinician. “White bagging” is where insurers require medications to be dispensed by a specialty pharmacy and delivered to a hospital, infusion center, pharmacy or physician’s office for administration to a specific patient.  In addition to patient safety concerns, both practices pose troublesome legal predicaments with the state’s prohibition on the re-dispensing of pharmaceuticals.