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Finance Committee Chairman Baucus Acknowledges Need To Fix Home Infusion Therapy Medicare Coverage Gap; Commits To Identifying Solution

“There is certainly a gap in benefits…we do not cover home infusion therapy…we have to figure out a way to solve it,” Senate Finance Committee Chairman Max S. Baucus (D-MT) told committee members during day three of the Senate Finance Committee health reform markup sessions held September 22-25, 2009 (the Committee will resume their markup the week of September 28, 2009). Chairman Baucus pledged to identify a solution to the Medicare gap following Senator Blanche L. Lincoln’s (D-AR) call for complete coverage of home infusion therapy under Medicare. “I would very much like to figure out how to get at this problem because it is not fair,” he stated.

In an amendment offered to the Finance Committee, Senator Lincoln described the gap in Medicare coverage, talked about the legislation she sponsored with Senator Olympia J Snowe (R-ME), declared that Medicare must be brought in line with private payers and other government programs that have been covering home infusion therapy for decades, and requested Chairman Baucus' assistance in getting a comprehensive Congressional Budget Office (CBO) scoring on the proposed legislation.

Following Chairman Baucus’ commitment to identify a solution to the existing gap in Medicare coverage, Senator Lincoln withdrew the amendment with the expressed understanding that the Chairman would continue to work with her on the issue in an effort to include a home infusion coverage solution in the final health care bill. 


Important Next Steps for NHIA Members
Now more than ever, all NHIA members must actively request that their Senators reach out to the CBO to ensure that the scoring process is finalized in an accurate manner. The initial score assigned is preliminary and needs further technical corrections (something the CBO has been working on with the Centers for Medicare and Medicaid [CMS] to correct). The initial CBO score is believed to be erroneous and far too high, as it does not appear to realistically calculate the real costs of providing home infusion therapy—nor does it reflect the potential 10:1 savings ratio that home infusion therapy providers have identified (savings that could be provided to the Medicare program).

NHIA recognizes it will require “fresh approaches” on the part of both the CBO and CMS to truly capture the significant savings home infusion therapy can offer the Medicare program, while increasing the quality of patient care that can be provided through this legislative fix. We owe it to our patients, our nation and current (as well as future) Medicare recipients, to generate the commitment necessary to work together to help make this benefit for older and disabled Americans a reality.

To further grow our momentum, we urgently ask all NHIA members to contact their Senate offices immediately by phone, fax and e-mail indicating the need for a revised CBO score and requesting their support in making that happen.

There is no question that NHIA member outreach to their Senators is helping, and we need your support to keep the pressure on! Thanks again for your important advocacy!

Together, we will make the needed home infusion legislative fix a reality.