August 29, 2022 – Dozens of health systems, hospitals, and GPOs are asking congress to pass legislation to address Medicare reimbursement for home infusion services.
CMS and Medicaid Services did not properly implement the Bipartisan Budget Act of 2018, which requires a nurse to be physically present in the patient’s home for providers to be reimbursed. According to the National Home Infusion Association, “this fails to account for the extensive clinical and administrative services that are provided remotely by home infusion clinicians.”
These organizations are urging lawmakers to pass the Preserving Patient Access to Home Infusion Act, which provides technical clarifications that would remove the physical presence requirement. This would ensure payment regardless of the presence of a healthcare professional in the patient’s home.
If this legislation passes, it will increase provider participation in the benefit and enhance patient access to home infusion, diverting care from more expensive institutional settings. Many Medicare beneficiaries rely on IV drugs to better manage chronic disease or acute conditions, and those who are commercially insured already have this benefit.