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Press Release

Congressional Spending Bill Falls Short on Home Infusion

FOR IMMEDIATE RELEASE

Alexandria, VA (December 17, 2024)—The National Home Infusion Association (NHIA) expressed deep concern today regarding the recently proposed government funding bill, which includes major changes to the qualifying criteria for drugs under Medicare’s home infusion benefit but fails to address the underlying flaws that have plagued the program. Without fixing the structure of the benefit, Medicare beneficiaries in need of home infusions for treatment of a variety of medical conditions, including rare diseases, are unlikely to gain access to home-based care.

“The current home infusion benefit under Medicare is an outlier compared to the well-established commercial model and has failed to engage providers or patients. Expanding the list of eligible drugs without fixing these systemic barriers will result in less access than exists today,“ said Connie Sullivan, BSPharm, President and CEO of NHIA.

First launched in 2019, Medicare’s home infusion therapy (HIT) services benefit has failed to achieve its promise of delivering patient access to home infusion. According to CMS data, several U.S. states haven’t registered a single home infusion service visit. The same report found that less than 1,500 Medicare beneficiaries are receiving home infusion services each calendar quarter — and provider participation in the benefit has steadily declined since implementation. By contrast, passing the Preserving Patient Access to Home Infusion Act with changes proposed by NHIA could make home infusion available to hundreds of thousands of Medicare beneficiaries while significantly reducing federal spending.

The policy included in the government funding bill will have unintended consequences. Specifically, the text of the Joe Fiandra Access to Home Infusion Act would add certain rare disease drugs to Medicare’s external infusion pump benefit that require health care professional-administration. However, due to the lack of home infusion provider participation, patients requiring these therapies are expected to have challenges finding a provider. Furthermore, as the Congressional Budget Office concluded, the policy effectively reflects a cost shift from the federal government to patients, as the savings generated are “primarily because beneficiaries would bear a larger share of the cost of infusions that occur at home.”

NHIA is calling on Congress to urgently pass the Preserving Patient Access to Home Infusion Act, which would fix the broken home infusion benefit, reduce the cost of care, and broaden access. This bipartisan legislation — which enjoys support from dozens of stakeholder organizations and was widely supported at a hearing in the House Ways & Means Committee this year — includes critical reforms that will ensure beneficiaries living in rural areas and those with disabilities who depend on home access can find a qualified provider.

“Congress needs to act swiftly to rectify the situation, or beneficiaries are likely to find their home infusion options under Medicare are not what they expected. NHIA stands ready to continue our work with Congress to prioritize a fix to Medicare that meets the needs of America’s seniors and people with disabilities who rely on access to life-sustaining IV therapies.”

NHIA is a trade association that represents companies that provide infusion therapy to patients in their homes, as well as companies that manufacture and supply infusion and specialty pharmacy products. Infusion therapy involves providing medically necessary medications, supplies, and a range of pharmacy, nursing, and other clinical services to safely furnish care to patients in the home setting. For more information, visit www.nhia.org.

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