POLICY AND ADVOCACY

As the leading voice for home infusion on Capitol Hill and with the Administration, NHIA is fighting to ensure that federal policy supports equitable access to the full range of home infusion therapies.

Current Policy Initiatives

Preserving Patient Access to Home Infusion Act (117^th Congress)

In 2016, Congress passed the 21^st Century Cures Act, which included reforms to the Medicare Part B DMEPOS program. To ensure home infusion services were not interrupted, Congress added a new Home Infusion Therapy Services benefit to Medicare Part B.

Unfortunately, the Centers for Medicare and Medicaid Services (CMS) has interpreted the home infusion services benefit as one that covers professional services provided in the patient’s home (i.e. nursing) to administer IV or SC medications. Despite a letter from the Congressional sponsors of the home infusion legislation, numerous comments through the rule-making process, and drops in utilization, CMS has not moved from their flawed definition of “home infusion calendar day.”

Letter to HHS from Senate bill sponsors
Letter to HHS from House bill sponsors

NHIA has drafted legislation with the help of our Congressional champions to permanently fix the home infusion therapy services benefit. The legislation (S.2652; H.R. 5067) was introduced in August 2021 and will accomplish the following if passed:

• Require CMS to pay home infusion providers for professional services each day the drug is administered.
• Remove the requirement that a skilled professional be present in the home for billing to occur.
• Explicitly acknowledge pharmacy professional services.
• Keep all drugs in the benefit that were part of the transitional program (i.e. Hizentra)

Status:

• Introduced, pending committee hearings, mark up, and scoring.
• Recruiting co-sponsors

How you can help

• Contact your Senators and Representatives and ask them to co-sponsor H.R. 5067 and S. 2652.
• Write an op-ed for your local paper about how home infusion has supported patients during the COVID-19 pandemic.
• Invite patients to share their stories with NHIA about how home infusion has positively impacted their lives.

Policy Resources
In addition to the work NHIA has done on Medicare Reimbursement, we have been active on issues related to sterile compounding, insanitary conditions, and revisions to USP <797> and <800>. Click here for additional information on these activities.

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• Policies to Improve Home Infusion Reimbursement: Fiscal Implications (Jan 2020)
• Home Infusion Talking Points for Capitol Hill
• Home Infusion Creates Savings for Patients, Taxpayers
• CMS Policy Threatens Access to Home Infusion
• CMS Data Shows Impact of Home Infusion Reimbursement
• Template for Members and Stakeholders
• Medicare Coverage of Home Infusion Professional Services Written Statement of Congressman Eliot L. Engel Member Day Hearing
• NHIA’s Statement before the Food and Drug Administration on Draft MOU
• NHIA’s Comments to the Food and Drug Administration on the Draft MOU
• NHIA’s Comments on Insanitary Conditions Guidance
• Federal Regulation and the Drug Quality and Security Act (DQSA)
• NHIA Compounding Standards Resource Center