Re-introduced legislation seeks to modernize home infusion benefit 

WASHINGTON – Members of the House of Representatives and the Senate have re-introduced legislation that would create a complete home infusion benefit for Medicare beneficiaries with conditions that require an infusion pump. 

The “Preserving Patient Access to Home Infusion Act” would: 

• Provide technical clarifications that would remove the physical presence requirement, ensuring payment regardless of whether a health care professional is present in the patient’s home; 
• Acknowledge the full scope of professional services and maintain the current reimbursement rate for in-person nursing visits for at least five years; and 
• Expand the availability of home infusion to additional patients by making IV anti-infectives available under the home infusion benefit.   

“Home-based infusion services are a vital component in improving access to life-sustaining IV treatments and enhancing the quality of life for patients and their families, while adding capacity to the health care system,” said NHIA President & CEO Connie Sullivan, BSPharm. “Passage of the Preserving Patient Access to Home Infusion Act will modernize Medicare’s coverage of home infusion, bringing it in line with the commercial sector, and finally achieve Congress’ intent with creating the benefit.” 

The legislation was introduced by Reps. Vern Buchanan, R-Fla., Diana Harshbarger, R-Tenn., Rep. Debbie Dingell, D-Mich., and Terri Sewell, D-Ala., in the House, and Sens. Mark Warner, D-Va., and Sen. Tim Scott, R-S.C., in the Senate. 

The home infusion benefit, first launched in 2019, has failed to achieve is promise of delivering patient access to home infusion, say supporters of the legislation. They cite data from CMS show that several states haven’t registered a single home infusion service visit and that fewer than 1,500 Medicare beneficiaries are receiving home infusion services each calendar quarter. 

For more information on the legislation, go here. 

• Related: Earlier this year, stakeholders, with feedback from the Congressional Budget Office, were working with lawmakers from both sides of the aisle to modify previous bills to improve Medicare’s home infusion benefit.