On October 31st, the Centers for Medicare and Medicaid Services (CMS) issued a policy that will impair seniors’ ability to receive infusion services in the safety and comfort of their homes. As written, the CY 2019 Final rule on Home Infusion Therapy Requirements only reimburses on a day a nurse or other professional is physically present in the patient’s home. This limitation effectively reduces home infusion to a nursing benefit, and belies the operational and practical realities of delivering home infusion services.
NHIA is actively working to combat this rule. We are submitting comments and continuing to advocate with CMS to encourage them to change the policy to allow for reimbursement of the entire range of professional pharmacy-related services in addition to nursing. These services would include initial and ongoing assessment, clinical care planning, drug preparation and delivery, care coordination, nursing, and other professional services typically offered by a pharmacist.
We are also working on legislation that would correct the Agency misinterpretation of the law and require that home infusion services be reimbursed on any day on which a patient receives infusion of Part B covered drugs, and that reimbursement should occur irrespective of whether a professional is present in the patient’s home.
We need your help! We are also asking all our members to call on Congress to enact legislation in the lame duck session that would reverse this ruling and require CMS to implement the transitional payment as Congress originally intended. Click here to:
Learn about the new law and how it will affect your infusion business. Gain insight into the July 2, 2018, CMS proposed rule that jeopardizes the new law.Click here