More than 35 diverse stakeholder groups — ranging from associations of health-care professionals to consumer organizations — have signed a letter asking Congress to support and advance the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104).
In a Nov. 12 announcement, National Home Infusion Association (NHIA) President/CEO Connie Sullivan, BSPharm, said, “Home infusion improves patient outcomes, prevents unnecessary hospital and long-term care stays, and leads to substantial efficiencies for both patients and the Medicare program. By aligning Medicare policy with the successful models already in use by commercial insurers, we can expand home infusion access to those who need it most — America’s seniors and those living with disabilities.”
Groups signing onto the letter — sent to Senate Majority Leader Charles Schumer (D-N.Y.), Speaker of the House Mike Johnson (R-La.), Senate Minority Leader Mitch McConnell (R-Ky.), and House Minority Leader Hakeem Jeffries (D-N.Y.) — included the Alliance for Pharmacy Compounding, the ALS Association, the American Association for Homecare, the American Society for Parenteral and Enteral Nutrition, Dysautonomia International, the Hospital-Owned Specialty Pharmacy Alliance, the Infusion Nurses Society, the National Association for Home Care & Hospice; the National Community Pharmacists Association; the National Home Infusion Association, and the Society of Thoracic Surgeons.
“Home infusion services have long been a critical component of patient-centered care, allowing
individuals to receive necessary intravenous (IV) and subcutaneous therapies in the comfort of their
homes,” the letter said. “The availability of this care model is critical to a properly functioning health-care system, as access to home infusion is essential for beneficiaries with disabilities and those living in rural areas. Additionally, home infusion improves patient outcomes, alleviates pressure on facilities, prevents unnecessary long-term care stays, and leads to substantial efficiencies for both patients and the Medicare program.
“Despite these clear benefits, the current Medicare home infusion therapy (HIT) benefit is failing to
function as Congress intended and is not meeting the needs of Medicare beneficiaries. While
Medicare’s home infusion benefit was created in 2017 by the 21st Century Cures Act, the Centers for
Medicare & Medicaid Services (CMS) has implemented the benefit in a manner that has failed to
attract meaningful participation from providers and has left several states without a single
participating HIT supplier. Beyond that, Medicare beneficiaries that would rely on home infusion for
routine treatments such as IV antibiotics are often surprised to find out that Medicare’s benefit does
not provide coverage for the services and supplies required for home infusion. The resulting gaps in
coverage disproportionately affect some of our most vulnerable populations, limiting access to high-quality, at-home care.”
“The Preserving Patient Access to Home Infusion Act provides technical clarifications that will remove the physical presence requirement, ensuring payment regardless of whether a health-care professional is present in the patient’s home,” the NHIA announcement said.
“The legislation also acknowledges the full scope of professional services provided in home infusion — including essential pharmacist services — into the reimbursement structure. If implemented, this legislation would increase provider participation in the benefit and enhance patient access to home infusion, effectively diverting care to the home that would otherwise be delivered in more expensive institutional settings.”
“Medicare beneficiaries with chronic conditions such as dysautonomia are often unable to access home infusion services, leaving them without essential treatments that help manage their disease,” Lauren Stiles, JD, president/CEO of Dysautonomia International, said in the NHIA announcement. “For these individuals, the physical toll of traveling to outpatient infusion clinics is often too great, leading to poorly managed symptoms and, ultimately, more emergency room visits. Congress has the opportunity to address this urgent need by passing the Preserving Patient Access to Home Infusion Act, ensuring that Medicare beneficiaries can receive critical care in the comfort of their homes and avoid unnecessary hospitalizations.”