Bill aims to maintain access to home infusion therapy

WASHINGTON - Sens. Mark Warner, D-Va., and Tim Scott, R-S.C., have introduced legislation that uses technical clarifications to remove the requirement that a nurse or other health care professional be present in the patient’s home for the home infusion provider to be paid for those services. 

The Preserving Patient Access to Home Infusion Act also incorporates the full scope of professional services provided through home infusion — including essential pharmacist services — into the reimbursement structure. 

“Home-based health care services stand out as high-value resources that can improve patient quality of life and add capacity to the health care system, while keeping vulnerable patients away from the threat of infectious disease,” said Connie Sullivan, president and CEO of the National Home Infusion Association. “Passage of the Preserving Patient Access to Home Infusion Act is critical to ensuring the Medicare program maintains access to home infusion, allowing beneficiaries to safely receive treatment in the setting they overwhelmingly prefer: their homes.”  

Per the 21st Century Cures Act, which created a professional services benefit for Medicare Part B home infusion drugs, CMS published a final rule in 2018 that limits reimbursement for professional services to only those days a “skilled professional is in the home.” Stakeholders say the rule ignores congressional intent.   

In June, a U.S. district court dismissed a lawsuit filed by the NHIA against the Department of Health and Human Services over the implementation of the professional services benefit for a “lack of subject matter jurisdiction.”