NHIA: New House & Senate Bills Would Improve Home Infusion Access for Medicare Patients

• By Laurie Watanabe
• Jun 22, 2023

The National Home Infusion Association (NHIA) said it “applauds” two new bills — one in the House, one in the Senate — that would “ensure Medicare patients can receive the intravenous (IV) medications they need while at home.”

In a June 14 announcement, NHIA praised S. 1976 — introduced by Sen. Mark Warner (D-Va.) and Sen. Tim Scott (R-S.C.) — and H.R. 4104 ‚ introduced by Rep. Vern Buchanan (R-Fla.), Rep. Diana Harshbarger (R-Tenn.), Rep. Debbie Dingell (D-Mich.), and Rep. Terri Sewell (D-Ala.). Both bills are being called the Preserving Patient Access to Home Infusion Act, and the NHIA said the legislation “would greatly improve home infusion access for Medicare patients with serious viral and fungal infections, heart failure, immune diseases, cancer, and other conditions that require the use of an infusion pump.”

NHIA President/CEO Connie Sullivan, BSPharm, said in the announcement, “Home-based infusion services are a critical 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 healthcare system. Passage of the Preserving Patient Access to Home Infusion Act is critical to ensuring Medicare beneficiaries maintain access to home infusion, allowing them to safely receive treatment in the setting they overwhelmingly prefer: their homes.”

Home Infusion a Proven Intervention for Many Years

“Home infusion pharmacies have been safely and effectively providing a wide range of IV medications to patients in their homes for over 40 years,” NHIA said in the announcement. “This proven model of care is critically important for patients living in rural areas, who are disabled, or have transportation challenges. Additionally, home infusion has shown to be a cost-effective alternative when compared to other sites of care. Home infusion was heavily utilized during the COVID-19 public health emergency, which prompted a larger shift to home-based health services that has outlasted the crisis.”

The association pointed to a Medicare demonstration project, reported on in August 2022, “that studied bundled payment for items and services, such as infusion supplies and nursing services, related to IV immune globulin (IVIG) administration in the home.”

The results, NHIA said, showed successes on multiple levels: “Clinical measures suggest increased medication adherence and better disease management. In addition, enrollees reported reduced transportation barriers, reduced risk of infection, increased treatment compliance, and improved monitoring.”

NHIA noted that in the 21st Century Cures Act from 2016, “Congress intended to create a comprehensive Medicare home infusion benefit for Part B DME drugs,” but that “flawed implementation by CMS [Centers for Medicare & Medicaid Services] has led to major access issues for Medicare beneficiaries.”

The bills now in the U.S. House and Senate “would restore Congressional intent and promote access to home-based care by mirroring the successful model employed by nearly every commercial plan,” NHIA said, noting that it “drafted legislation with the help of our Congressional champions to permanently fix the Part B home infusion therapy services benefit.”

The bills would require CMS to pay home infusion providers for professional services each day the drug is administered; would remove the requirement that a skilled professional be present in the home for the billing to occur; and would define the covered pharmacy professional services, NHIA noted.

For more information on the bills, visit NHIA’s resource page, which includes the history and background of the legislation being sought, and offers policy resources such as a one-page summary of the Preserving Patient Access to Home Infusion Act, and an infographic of the bills.