Preserving Patient Access to Home Infusion
The National Home Infusion Association held 130+ congressional meetings as part of its annual Advocacy in Action Day
By Michelle Love
The National Home Infusion Association (NHIA) held its annual Advocacy in Action Day in November, during which association members and patients met with members of Congress and their staff to advocate for a fix to the Medicare home infusion coverage gap. Over the course of the event, NHIA members held more than 130 meetings in support of the Preserving Patient Access to Home Infusion Act (HR 2172 and S 1058).
Rep. Vern Buchanan, vice chairman of the House Ways and Means Committee and chairman of the Health Subcommittee, introduced the legislation back in March with Reps. Debbie Dingell (D-Mich.), Dianna Harshbarger (R-Tenn.) and Terri Sewell (D-Ala.). The bipartisan bill ensures patients with serious infections, heart failure, immune diseases, cancer and other conditions can receive the intravenous (IV) medications they need while at home. Companion legislation was introduced by Sens. Mark Warner (D-Va.) and Tim Scott (R-S.C.).
NHIA members representing provider and supplier companies, along with patients who depend on home infusion services, participated in the event to share their experiences and discuss the critical need to modernize Medicare coverage for home infusion therapy.
Voices in Support
“Home-based infusion is a proven, patient-preferred model that delivers safe, effective care while lowering costs and relieving pressure on hospitals and skilled facilities. We’re grateful to our bipartisan champions … for leading on this critical issue. NHIA will continue to fight for seniors who need timely access to home infusion services. It’s time for Medicare to evolve and catch up to the private sector, where patients can receive care in their preferred setting—the home—while reducing total health care costs.”
—NHIA President and CEO Connie Sullivan
“Home health services are invaluable for the nearly 200,000 seniors in my district and anyone in need of accessible, convenient care. The Preserving Patient Access to Home Infusion Act will ensure that Medicare recipients are able to continue to receive life-saving drugs in a safe and effective way from the comfort and convenience of their own home.”
—Rep. Vern Buchanan
“We have seen for years that patients are better off when they can receive quality care from the comfort of their own homes. This legislation would ensure that millions of Americans who suffer from life threatening conditions such as immune diseases, cancer, serious infections, and heart failure can receive the care they need without having to make frequent, sometimes costly trips to the hospital.”
—Sen. Mark Warner
Why Action Is Needed
Medicare’s home infusion therapy services benefit is limited to about 36 drugs that require infusion pumps for administration. According to NHIA, it doesn’t provide adequate coverage for pharmacy professional services that make home infusion possible. As a result, few home infusion pharmacies participate in the benefit, limiting access. This contrasts with commercial insurance payers that make home infusion readily available for more than 300 unique drugs and biologics, including IV anti-infectives.
Each year, an estimated one million Medicare patients are diverted to outpatient departments or skilled nursing facilities to receive IV anti-infective therapies because of coverage limitations. This increases health care costs and restricts patient choice and access to clinically appropriate care at home.
The bill would modernize Medicare’s home infusion therapy benefit by closing existing coverage gaps and recognizing pharmacy professional services essential to the safe delivery of care in the home, as well as expanding care for Medicare beneficiaries who require IV anti-infective treatments.
Michelle Love is associate editor for HomeCare Media.
