August 8, 2022
Rep. Earl L. “Buddy” Carter (R-GA.), one of two pharmacists in Congress, penned an op-ed, “Four years later, Medicare policy is still failing home infusion therapy patients” recently published in The Hill. The article highlights flaws in CMS’ implementation of the Home Infusion Therapy Services benefit that is limiting access to these services.
Carter says, “…almost four years into the creation of a new Medicare benefit designed to promote access to home infusion, this vital health program is failing to keep up with the needs of America’s seniors.”
Unlike all other payers—including commercial plans, Medicare Advantage Plans and others—CMS instituted an unnecessary requirement that a skilled professional be physically present in the patient’s home on the day of administration for Medicare reimbursement to occur.
“This fundamentally defeats the purpose of home infusion, which is to give patients the freedom to receive and administer their infusions at home without a health care professional” says Carter.
This insufficient reimbursement for the extensive services home infusion pharmacies provide jeopardizes Medicare beneficiaries’ access. According to CMS’ own data, less than 1,300 Medicare beneficiaries accessed the benefit each calendar quarter from Q1 2019 to Q1 2021.
“Without access to home infusion, Medicare beneficiaries are instead being directed to institutional settings–increasing costs to both patients and federal taxpayers while unnecessarily inconveniencing patients that don’t otherwise need to be in facilities to receive their care” says Carter.
Legislation before Congress, the Preserving Patient Access to Home Infusion Act (H.R 5067; S.2652) would fix CMS’ failed implementation of the HIT services benefit by providing coverage for infusion services every day a drug is infused, rather than only on days when a skilled professional is physically present.
We are grateful for Rep. Carter’s support of this issue and the Preserving Patient Access to Home Infusion Act.
NHIA commented on CMS’s Information Collection Request (ICR) regarding the Medicare Transaction Facilitator (MTF) that will be used in facilitating negotiated prices under the Medicare Drug Price Negotiation program.
The National Home Infusion Association (NHIA) is pleased to announce that Greg LoPresti, CEO Upstate HomeCare has been named Chair of its Board of Directors. LoPresti will lead the trade association representing companies that provide medically necessary infusion therapies to patients in alternate sites, as well as companies that manufacture and supply infusion and specialty pharmacy products.
Last week concluded the 2025 National Home Infusion Association Annual Conference (NHIA 2025), which brings together 1,600 home and alternate site infusion professionals for four days of networking, education, and exhibits. This year’s event saw significant growth in individuals investing to attend the event and the expo featured 150 companies displaying the latest products and services supporting the industry.
