Bill Aims to Expand Medicare Home Infusion Therapy Benefit
95 Percent of Patients Prefer Receiving Infusions at Home
WASHINGTON — Congressman Vern Buchanan, Vice Chairman of the House Ways and Means Committee and Chair of the Health Subcommittee, introduced the Preserving Patient Access to Home Infusion Act with Reps. Debbie Dingell (D-Mich.), Dianna Harshbarger (R-Tenn.) and Terri Sewell (D-Ala.). This bipartisan bill would ensure patients with serious infections, heart failure, immune diseases, cancer and other conditions receive the intravenous (IV) medications they need while at home. Companion legislation will be introduced in the U.S. Senate by Sens. Mark Warner (D-Va.) and Tim Scott (R-S.C.).
“Home health services are invaluable for the nearly 200,000 seniors in my district and anyone in need of accessible, convenient care,” said Buchanan. “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.”
“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,” said Sen. Warner.
“When looking at the challenges high-risk patients face, comfort and convenience shouldn’t be one. This legislation takes a commonsense approach to implementing necessary reforms so Medicare recipients can continue receiving critical treatment from the comfort and safety of their homes without a costly hospital visit,” said Sen. Scott.
“Expanding at-home care not only enhances patient comfort but also offers substantial cost savings for both patients and providers. The legislation’s commonsense reforms will expand access to home infusion services for Medicare beneficiaries, saving the Medicare program millions of dollars, cutting patient costs, and ensuring people receive safe and adequate care in the comfort of their own home. I look forward to working with my colleagues to move this bipartisan legislation forward so we can effectively care for people and save money by doing so in a home setting,” said Rep. Dingell.
When given the option, patients overwhelmingly prefer to receive their infused drugs at home where they are most comfortable and can resume their personal and professional lives. Research shows that up to 95 percent of patients would prefer receiving their infusions at home.
Despite congressional intent, the Centers for Medicare and Medicaid Services (CMS) improperly implemented the benefit for Medicare Part B home infusion drugs by requiring a nurse to be physically present in the patient’s home in order for providers to be reimbursed. As a practical matter, the current home infusion therapy benefit only acknowledges face-to-face visits from a nurse and fails to account for the extensive clinical and administrative services that are provided remotely by home infusion clinicians. As a result, provider participation in Medicare’s home infusion benefit has dropped sharply and beneficiaries have experienced reduced access to home infusion over the last several years.
Buchanan’s 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 legislation also acknowledges the full scope of professional services provided in home infusion—including essential pharmacist services—into the reimbursement structure.
“As a pharmacist for over 35 years, I know firsthand the importance of providing comfortable and accessible care for patients. We shouldn’t make it harder for our most vulnerable to receive the care they need. Receiving medical care—especially infusion-based treatments—is already daunting enough as it is. Some folks can’t get to places of treatment easily, there can be an increased risk of getting sicker due to higher exposure, the list goes on and on. This is common sense legislation and I’m proud to support it,” said Rep. Harshbarger.
“It has never been more critical to ensure patients continue to receive home infusion care safely in their homes. I am proud to introduce this bipartisan bill allowing countless Alabamians, especially those in rural communities, access to reliable home infusion services for life-saving care. I urge my colleagues on both sides of the aisle to give this legislation their full support,” said Rep. Sewell.
Buchanan’s legislation is supported by numerous leading health care stakeholders, including the National Home Infusion Association, Option Care Health, Alliance for Pharmacy Compounding, American Academy of Home Care Medicine, American Association for Homecare, American Association of Neuromuscular & Electrodiagnostic Medicine, American Society for Parenteral and Enteral Nutrition, American Society of Consultant Pharmacists, Fabry Support & Information Group, Gaucher Community Alliance, GBS | CIDP Foundation International, Healthcare Nutrition Council, Hemophelia Federation of America, Hospital-Owned Specialty Pharmacy Alliance, Infusion Nurses Society, Moving Health Home, Muscular Dystrophy Association, Musella Foundation For Brain Tumor Research & Information, Inc., Myasthenia Gravis Foundation of America, Myasthenia Gravis Hope Foundation, National Alliance for Care at Home, National Association of Specialty Pharmacy, National Partnership for Healthcare and Hospice Innovation, NTM Info and Research Inc., Patients Rising, Plasma Protein Therapeutics Association and US Hereditary Angioedema Association.
“We applaud Congressman Buchanan and the other bill sponsors for their leadership in advancing legislation that ensures Medicare patients have access to home infusion therapy. Home-based infusion services are a vital component in improving access to life-sustaining IV treatments and enhancing the quality of life for patients and their families, while also adding capacity to the health care system. By reducing unnecessary facility stays, overcoming transportation challenges, and expanding access in rural areas, this legislation takes a critical step toward ensuring Medicare beneficiaries can receive high-quality infusion care where they prefer—at home,” said Connie Sullivan, President and CEO, National Home Infusion Association.
“We’ve known for many years that home infusion services can be safe, efficient and cost-effective. The Preserving Patient Access to Home Infusion Act would restore congressional intent and promote broader access to home-based care by giving Medicare beneficiaries greater ability to be treated in their site of care of choice. We strongly support the Preserving Patient Access to Home Infusion Act and urge Congress to take immediate action on this bill,” said John C. Rademacher, President and CEO, Option Care Health.
“On behalf of the undersigned organizations representing key stakeholders across the U.S. health care system, we extend our deepest gratitude for your leadership in championing the Preserving Patient Access to Home Infusion Act. We are writing to express our strong support for this vital legislation and to recognize the importance of your continued commitment to protecting patient-centered care,” wrote the supporting organizations.
Buchanan has consistently fought to extend flexible health care options to Americans in need of timely care. Last month, he introduced the Permanent Telehealth from Home Act (H.R. 1407) to remove obstructive geographic limitations to telehealth services and the Lung Cancer Screening and Prevention Act (H.R. 1406) to help ensure timely access to advanced screenings for lung cancer. Last week, Buchanan’s Chronic Disease Flexible Coverage Act (H.R. 919), which expands treatment options provided through employers’ healthcare coverage for Americans living with chronic diseases, passed the House with a unanimous bipartisan vote.
In addition to being the Vice Chairman and most senior Republican on the powerful U.S. House Ways and Means Committee, Buchanan is also the Chairman of the Health Subcommittee, which has broad jurisdiction over traditional Medicare, the Medicare prescription drug benefit program, and Medicare Advantage.
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