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POLICY AND ADVOCACY

RURAL SERVICES INITIATIVE

In 2021, We Need Your Support

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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

Technician Compounding in New York State 

Summary

NHIA has been actively pursuing legislation in the state of New York to address the restrictions against pharmacy technician participation in sterile compounding activities. NHIA has successfully reintroduced legislation in both chambers of the NY legislature. Assembly bill 1090 (sponsor: Bronson) and Senate bill 2025 (sponsor: May), if passed, would permanently eliminate the restrictions on home infusion providers to use technicians to perform sterile compounding activities. 

Currently, home infusion is exempt from the NY law banning the use of technicians due to language included in the governor’s emergency executive orders related to the COVID-19 pandemic. The executive order exemption is currently in effect until May 27, 2021. As the public health emergency orders begin to wind down, it is critically important that state legislators hear from home infusion providers about the need for permanent legislation to fix this issue. 

Therefore, NHIA is calling on all residents of NY to contact your state representatives and ask for their support of A. 1090 and S. 2025. The attached document provides instructions and talking points for use in contacting your state legislators. We ask that you begin your outreach immediately and encourage your co-workers to participate in this effort. 

If you have questions about the legislation, or the talking points (download a script here), please don’t hesitate to reach out to me via email here.

Preserving Patient Access to Home Infusion Act (116th Congress)

Summary

In 2016, Congress passed the 21st Century Cures Act, which included reforms to the Medicare Part B DMEPOS program including changing the payment methodology for drugs from Average Wholesale Price to Average Sales Price. To ensure home infusion services were not interrupted, Congress added a new Home Infusion Therapy Services benefit to Medicare Part B. Since the new benefit created by Cures does not start until 2021, Congress included a home infusion services temporary, transitional benefit in the Bipartisan Budget Act of 2018, in an effort to bridge the gap until the permanent benefit would begin.

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 (H.R. 6218, S. 3457) was introduced in March 2020 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. 6218 and S. 3457.
  • 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.