FOR IMMEDIATE RELEASE
September 12, 2014
Proposed Home Infusion Legislation Would Save Millions of Dollars, Enhance Care for Medicare Patients
Washington, DC—The National Home Infusion Association (NHIA) today applauded Representatives Eliot Engel (D-NY-17) and Pat Tiberi (R-OH-12) for their leadership in introducing The Medicare Home Infusion Site of Care Act (H.R. 5435), a bill that will help to reduce Medicare spending while providing beneficiaries with much needed access to safe, high-quality, life-saving home infusion therapy denied to them under the current program.
“The current Medicare exclusion for in-home infusion must be corrected. Patients battling cancer or suffering from a serious infection should be able to receive quality care, at a lower cost, in their own home. Under the current guidelines patients must go elsewhere for treatment, often against the better judgment of their doctor or their own desire,” said Congressman Engel. “This puts them at a higher risk for infection, and treatment costs are usually far higher than if the therapy were provided at the patients’ home.”
Congressman Engel also noted in his release that Avalere, a non-partisan health care policy firm, recently found that Medicare could save an estimated $80 million over a 10-year period by covering home-based infusion therapy treatment. The Medicare Home Infusion Site of Care Act (H.R. 5435) would allow Medicare Part B to cover infusion-related care and services, including equipment and supplies, at a patient’s home.
Infusion therapy is fully covered by Medicare in hospitals, skilled nursing facilities, hospital outpatient departments, and physician offices but not in a patient’s home which is the setting that is the most desirable, convenient, and most cost-effective.
The bi-partisan bill will allow patients fighting severe infections, cancer, or chronic diseases to receive their infusion treatments in the convenience of their homes rather than be forced to undergo therapy in a site of care that is more costly, taxing to patients and their families, and compromises the health of an infusion patient who is at a higher risk of acquiring healthcare-associated infections.
Infusion therapy in the home has been the accepted standard of care and practice within the private sector for more than 30 years and is covered by private insurers including State Medicaid programs, Medicare Advantage, Tricare, the Veteran’s Administration, and the Federal Employee Health Benefits Plan. Medicare Fee-for-Service is the only major payer that does not cover all the essential components of home infusion therapy. While Medicare covers most infusion drugs, it does not cover the infusion-related services, equipment, and supplies required to safely administer the therapy. The Medicare Home Infusion Site of Care Act (H.R. 5435) would close this illogical gap in coverage.
“Ironically, patients who have access to this benefit under their private plans lose their coverage when they enroll in Medicare,” said Congressman Tiberi. “This is unfortunate and unnecessary,” he said. “Medicare’s lack of coverage of infusion therapy in the home setting can lead to substantial beneficiary lifestyle disruptions and costs. Because Medicare covers infusion services in institutional settings, the beneficiary either has to travel to a health care facility or remain in a facility for the duration of the treatment,” Congressman Tiberi added.
“The introduction of The Medicare Home Infusion Site of Care Act (H.R. 5435) represents a long overdue, common sense solution to improving patient care while providing much needed relief to the ongoing Medicare crisis,” said Russell Bodoff, NHIA President and CEO. “The time is right for legislation that will help to contribute toward building a sustainable health care system that is efficient, geared toward the real needs of individual patients, and cost-effective.”
The National Home Infusion Association, based in Alexandria, Virginia, represents organizations that provide infusion and specialized pharmacy products as well as the interests of Medicare patients unable to get home infusion therapy. For more information, visit the association at www.nhia.org