A new state law gives independent practices and infusion centers control over how they source and bill for clinician-administered drugs.
Most independent physician practices and outpatient infusion centers in New Hampshire don't realize that insurers and pharmacy benefit managers (PBMs) have been able to force them into "white-bagging" or "brown-bagging" arrangements without their agreement. A provision buried in SB256 changes that—and it matters to your bottom line.
White-bagging and brown-bagging are supply-chain arrangements where an insurer or PBM requires a medical practice to use drugs that the insurer or PBM sources and ships directly to the practice, rather than allowing the practice to purchase drugs through its own supplier. The practice administers the drug to the patient but cannot mark up the drug acquisition cost or earn the associated administration fees the way it would with drugs it bought itself.
For small practices and infusion centers, this arrangement can significantly reduce revenue. The margin on drug acquisition and the fees tied to administration are often critical to keeping these businesses viable.
Section 1 of SB256, codified at RSA 420-J:28(I), prohibits insurers and PBMs from mandating white-bagging or brown-bagging arrangements without the practice's written consent. In plain terms: insurers can no longer force you into these supply chains. They can still offer them, but only if you agree in writing.
This restores your ability to source and bill for clinician-administered drugs directly—preserving the revenue stream tied to drug acquisition margin and administration fees that many small practices depend on.
The law applies to independent physician practices and outpatient infusion centers—the small and mid-sized businesses that don't have the negotiating power of large health systems. If you administer drugs to patients and have faced pressure from insurers to accept their drug supply, this provision protects your right to say no and maintain control over your supply chain.
The provision becomes effective January 1, 2027. That gives practices time to review current insurance contracts and plan for any changes to payer relationships or supply arrangements.
Review your current insurance contracts to identify any existing white-bagging or brown-bagging mandates. Starting January 1, 2027, you have the legal right to refuse these arrangements unless you've given written consent. If you have questions about how this applies to your specific contracts or payer relationships, consult with your practice attorney or business advisor.
Source: New Hampshire SB256, Section 1, RSA 420-J:28(I), page 2.