January 22, 2026
The Infusion Providers Alliance (IPA) submitted statements for the record ahead of hearings before the House Committee on Energy and Commerce and Committee on Ways and Means with health insurance company Chief Executive Officers.
Our comments focused on the vertical integration of insurers with pharmacy benefit managers (PBMs), specialty pharmacies, and other subsidiaries that are raising costs and harming patient access to therapies relied upon by individuals living with complex and chronic conditions. Specifically, we highlighted business practices these companies are adopting, including specialty pharmacy mandates, sometimes referred to as “white bagging” and self-administration mandates imposed on patients who may wish to continue to receive their medication in a healthcare setting administered by highly trained practitioners.
These mandates can increase patients’ out-of-pocket costs by shifting coverage from the medical benefit to the pharmacy benefit, where co-pays and deductibles are often higher and, in some cases, force patients to pay through two separate deductibles for the same course of treatment. Providers report that insurer-mandated specialty pharmacy white bagging can lead to damaged or delayed drug shipments and an inability to adjust dosing at the time of care, forcing patients to reschedule appointments and potentially miss or delay critical treatments, among other issues.
Evidence shows that community-based, non-hospital infusion providers deliver comparable or better clinical outcomes at lower cost and with higher patient adherence than hospital outpatient or other settings. Unfortunately, specialty-pharmacy and self-administration mandates can threaten patient access and clinical outcomes, undermine provider viability, and contribute to increased costs.
As policymakers consider future hearings and potential legislation, IPA urges Congress to:
- Protect medical benefit coverage for patients in non-hospital-based settings;
- Adopt nationwide bans or prohibitions on insurer specialty pharmacy mandates;
- Provide an exclusion from self-administration requirements for patients who wish to continue to receive treatments in a healthcare setting through their medical benefit; and
- Exclude and protect community-based, non-hospital providers, broadly defined as Place of Service 11 sites, from specialty pharmacy mandates.
Read IPA’s comments to the House Energy & Commerce Committee.
About the Infusion Providers Alliance
The Infusion Providers Alliance (IPA) is committed to protecting the integrity of the provider-patient relationship by empowering providers and patients to choose the most appropriate treatment together. We advocate for policies that ensure timely and adequate patient access to high quality care in IPA members’ convenient, community-based, non-hospital settings. IPA members operate over 1,000 in-office or stand-alone ambulatory infusion centers across 46 states nationwide, delivering value to the health care system and improved outcomes to patients.
All inquiries should be emailed to ewarren@infusionprovidersalliance.org.