Medicare Home Infusion Site of Care Act Advocacy Center
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Home Infusion Legislation Introduced by Senate and House Would Lower Medicare Spending; Enhance Patient Care
Alexandria, VA -- The National Home Infusion Association (NHIA) today applauded Senators Johnny Isakson (R-GA) and Mark Warner (D-VA) and Congressmen Eliot Engel (D-NY-16) and Pat Tiberi (R-OH-12) for their leadership in introducing The Medicare Home Infusion Site of Care Act of 2015, (S.275/H.R. 605), legislation 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.
“According to Avalere Health, a nationally recognized health care consulting firm, Medicare coverage of home infusion therapy would save taxpayers at least $80 million over 10 years,” Isakson stated. “This is good for the patient and good for Medicare's bottom line.”
“Home infusion therapy has been the accepted standard of care within the private sector for more than three decades, providing patients with high–quality infusion care in a setting that is often cheaper and more comfortable than a hospital or doctor's office – their homes,” said Senator Warner. “Medicare should allow physicians, in consultation with their patients, to judge where infusion services are best provided, whether that is at home or another facility."
Home infusion therapy is covered by private insurers including state Medicaid programs, Medicare Advantage plans, TRICARE, the Department of Veterans Affairs, and the Federal Employee Health Benefits Plan. Medicare is the only payor that does not cover all the essential components of home infusion therapy. While it covers most infusion drugs, Medicare does not cover the infusion-related services, equipment, and supplies required to safely administer the therapy.
“Correcting the current Medicare exclusion of in-home infusion therapy needs to be a priority for this Congress. Under current guidelines, patients battling cancer or suffering from a serious infection must leave their homes for infusion therapy treatment, often against the better judgment of their doctors. Leaving the house for this treatment not only puts the patient at a higher risk of infection, it also costs significantly more than it would if the therapy was provided in-home. There is no reason for us to continue making patients pursue a more dangerous and expensive method of infusion therapy treatment when there is a safer, more cost-effective alternative available,” Congressman Engel said.
“Ironically, patients who have access to this benefit under their private plans lose their coverage when they enroll in Medicare,” said Congressman Tiberi. “Medicare’s very limited coverage of infusion therapy in the home setting can lead to substantial patient and family lifestyle disruption and cost. Many beneficiaries either have to travel to a health care facility to receive infusion treatments, sometimes multiple times a day, or remain in a facility for the duration of their therapy.”
“The introduction of The Medicare Home Infusion Site of Care Act of 2015 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.
Read the Medicare Home Infusion Site of Care Act As Introduced in the Senate and the House of Representatives