White Bagging

What Is White Bagging?

White bagging is a practice where a patient purchases a drug from a specialty pharmacy, and the specialty pharmacy ships the drug to a provider office, hospital, or clinic for administration. If an insurer requires a patient to white bag, it is typically from a specialty pharmacy they are affiliated with.

Requiring a patient to white bag circumvents the traditional “buy-and-bill” model infusion providers rely on. Buy-and-bill allows infusion centers to manage their own drug inventory and bill for drugs administered to patients. Infusion providers have historically been able to offset the cost of administering complex medications through drug margins generated under the buy-and-bill model. Under a white bagging mandate, infusion providers go without proper reimbursement.

Anti-white bagging legislation has restricted or prohibited the requirement that patients obtain their drugs from a specialty pharmacy selected by their insurance company. Oftentimes, these laws will prevent insurance companies from conditioning coverage on the use of their specialty pharmacy.

White Bagging Legislative Map

When insurers or pharmacy benefit managers (PBMs) require patients to obtain clinician-administered medications through designated specialty pharmacies, rather than allowing infusion providers to acquire medications directly, it can disrupt care coordination, delay treatment, and create additional administrative and financial burdens. This practice, known as white bagging, can also limit providers' ability to manage medication inventory and maintain established safety protocols. This legislative map was created to help infusion centers, nurses, and healthcare professionals understand the state laws that may apply, including restrictions on mandatory white bagging, patient and provider choice, and insurer reimbursement requirements. Use this information to challenge potentially unlawful white bagging mandates, identify applicable protections, or contact lawmakers to advocate for reform where protections are lacking.

Click on a state to view applicable white bagging protections and requirements.

One thing to keep in mind: Some health plans — including many employer-sponsored plans — are regulated under federal law rather than state law. Additionally, white bagging protections may vary depending on whether a medication is covered under the medical or pharmacy benefit. Providers should review applicable state laws and plan requirements to determine which protections apply. Where protections do not exist or do not apply, providers and patients can contact their lawmakers to advocate for policies that preserve provider choice and patient access to care.