THE VALUED VOICE

A coalition of state and national health care organizations led by WHA has launched a public awareness campaign aimed at putting a stop to a health insurer practice known as “white bagging.” Growing opposition to the increasing and disruptive health insurer tactic has led a bipartisan group of ten Wisconsin lawmakers to introduce Koreen’s Law, named for an Eau Claire cancer patient whose health insurer’s specialty drug policy needlessly threatened the quality and reliability of the life-saving medication she desperately needed.
 
White bagging is a health insurer policy that requires certain medications to be purchased through specialty pharmacies often owned by the insurance company, instead of the patient’s preferred local health care provider. This practice disrupts care for patients with multiple sclerosis, cerebral palsy, cancer, rheumatoid arthritis and several other conditions by making these drugs out-of-network if dispensed by a pharmacy at a local health care provider and requiring patients to use a distant insurer-mandated pharmacy.
 
White bagging creates risks for patients like Koreen Holmes by sourcing drugs outside the normal supply chain and quality control process and create delays in medication administration that significantly affect patient health. In a recent survey by health care consulting firm Vizient, Inc., 83% of hospitals said that specialty medications delivered to them for patient administration through white bagging did not arrive on time, and another 66% of hospitals said that they have received the wrong dose.
 
To raise awareness of the dangers of white bagging among lawmakers, health care stakeholders and the general public and to advocate for its prohibition in Wisconsin, WHA established Patients First Wisconsin, a coalition of health care providers who have experienced firsthand the detrimental effects of white bagging on patient care. Learn more about Patients First Wisconsin and hear from Wisconsin patients affected by white bagging, including Koreen Holmes, at PatientsFirstWI.com.

Perspectives from many WHA members are also included on the Patients First Wisconsin website, and many hospital leaders have joined WHA in supporting Koreen’s Law, including Children’s Wisconsin Chief Quality Officer Chris Spahr, M.D. Spahr is concerned about how the growing trend of white bagging is disrupting the medication safety systems and the lives of the kids and families his hospital serves. “The focus on safety and safe system design in health care over the last two decades has improved care and outcomes tremendously for our patients, especially in the ordering, preparation and administration of medications,” he said. “The white bagging process that insurance companies are requiring patients to utilize to receive important medications circumvents the medication safety mechanisms that health systems have developed, leading to delays in care, waste, and poor outcomes.”
 
A Groundswell of Support
A Hospitals Education & Advocacy Team (HEAT) educational webinar on white bagging held on Oct. 22 drew 275 participants, including several from outside Wisconsin. WHA Vice President of Advocacy Kari Hofer, WHA Senior Vice President of Public Policy Joanne Alig and WHA Senior Vice President of Government Relations Kyle O’Brien provided an overview of what white bagging is and why legislation is needed.
 
The webinar also featured perspectives from Wisconsin health care providers, including Prevea Cancer Center at HSHS Sacred Heart Hospital (Eau Claire) Director of Oncology Angela Quick, who is Koreen Holmes’ health care provider. Quick and Ascension Wisconsin Oncology Financial Support Supervisor Lisa Gilbert provided compelling frontline accounts of dealing with white bagging and its impact on patients. Video excerpts of Quick’s and Gilbert’s addresses are available here.
 
WHA and its Patients First Wisconsin partners have also succeeded, with Koreen’s help, in attracting significant media attention, including an editorial by the Eau Claire Leader-Telegram stating, “There shouldn’t be a great deal of debate about this one. When insurance companies attempt to come between patients and the treatment they need by blocking medication or jacking the patient's cost through the roof, it’s an egregious act.”
 

Lawmakers Engaged
Koreen’s Law is authored by a bipartisan group of state lawmakers—Sen. Alberta Darling, Sen. Howard Marklein, Sen. Jon Erpenbach, Sen. Kathy Bernier, Rep. Tony Kurtz, Rep. Rob Swearingen, Rep. Evan Goyke, Rep. Jesse James, Rep. Rob Summerfield, and Rep. Warren Petryk. The bill’s lead authors are currently seeking co-sponsors for the bill.
 
Lead authors Sen. Alberta Darling (R-River Hills) and Rep. Tony Kurtz (R-Wonewoc) released a statement following circulation of the bill.
 
“Going through cancer treatment is stressful enough, the last thing anyone needs is for their insurance company to make it more difficult to get the medicine they need,” Darling said. “Our bill removes barriers to care and makes sure people get the drugs they need when they need them.”
 
“Patients should always be put first when it comes to their health care needs,” Rep. Kurtz said in the press release. “There is no reason a person should show up for life-saving treatments at a hospital, and the medicine isn’t there. This bill puts an end to that.”
 
To help garner lawmaker support for the bill, immediately following the webinar on white bagging, WHA launched a HEAT action alert to the 5,000 grassroots advocates in the HEAT network as well as to partner advocates of the Patients First Wisconsin coalition. The action alert called on advocates to contact their state lawmakers and ask them to cosponsor Koreen’s Law. In less than a week since the launch of the action alert on Oct. 23, the campaign has produced more than 2,000 grassroots messages to lawmakers in the Capitol.



WHA members and others interested in learning more about white bagging can visit PatientsFirstWI.com, where they can also take action on this important legislation by contacting their elected representatives and encouraging them to support Koreen’s Law.
 
Meet Koreen Holmes

Eight months into her pregnancy, Koreen Holmes and her husband Nate were focusing on final doctor appointments and diapers. When Koreen was told she had breast cancer, their world turned from a vibrant color to black and white.

“It was life or death,” said Koreen, who is just 32 years old. “Obviously, I chose life, which meant many months of cancer treatments and powerful medication.”
 
The expectant mom delivered her baby early—on Jan. 28, 2021, and treatments at the Prevea Cancer Center at HSHS Sacred Heart Hospital in Eau Claire began six days later. She required infusion treatments every three weeks.
 
Despite the curveball thrown at the Holmes family, they remained positive, and Koreen’s life-saving medications were working.
 
Then came July 1.
 
“We found out our insurance wasn’t going to pay for the medication anymore because the company put a new policy in place that dictated where we had to get the medicine from – something called ‘white bagging,’” said Nate.
 
Read more of Koreen’s story here.