The Joe Fiandra Access to Home Infusion Act & Other Steps
Proposed rule aims to bridge the gap in Medicare coverage for home infusion, but advocates say more should be done
By Michelle Love
Named in honor of an Army veteran who passed away in 2022 after a battle with amyloidosis, the Joe Fiandra Access to Home Infusion Act (HR 4993) was signed into law on Feb. 3. The law was designed to bridge a gap in Medicare coverage that prevented many patients from receiving medically necessary infusion therapy at home. The act expands Medicare coverage by ensuring that external infusion pumps and certain non-self-administered drugs are covered as durable medical equipment, removing obstacles to home-based treatment.
Regulators Weigh In
In its proposed rule for 2027 home health payments released in July, the Centers for Medicare & Medicaid Services included expanded coverage under Medicare’s durable medical equipment benefit to certain external infusion pumps and associated home infusion drugs. The new coverage would kick in April 1, 2027.
The language in the proposed rule aligns with the Fiandra Act and includes the following roles as the “healthcare professionals” allowed to administer infusion pumps in the home:
- Registered nurse
- Clinical nurse specialist
- Nurse practitioner
- Physician assistant
- Physician
The overwhelming majority of Medicare beneficiaries continue to lack meaningful access to home infusion because of fundamental flaws in the Medicare home infusion benefit. As a result, thousands of beneficiaries receiving intravenous anti-infectives, hydration, immune globulin, biologics and other infused medications continue to be directed to hospital outpatient departments and skilled nursing facilities despite home infusion often being the clinically appropriate, lower-cost and patient-preferred setting.
—The National Home Infusion Association
A Broader Option
The National Home Infusion Association (NHIA) said the proposal should not be viewed as a solution to the broader access challenges facing beneficiaries who would rather receive their infusions at home.
What Happens Next
NHIA is urging Congress to enact the Preserving Patient Access to Home Infusion Act (HR 2172, S 1058) to more fully address the disparity in access between Medicare and commercial coverage. This legislation would address the structural deficiencies in the Medicare home infusion benefit by ensuring beneficiaries can receive the professional services necessary to safely administer infused medications in their homes.
Michelle Love is associate editor for HomeCare Media.
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