NHIA denounces new proposed rule

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Tuesday, July 16, 2019

ALEXANDRIA, Va. – A proposed rule published last week fails to address a “deeply flawed policy” that reimburses home infusion services only on days when a nurse is present in the patient’s home, says the National Home Infusion Association. “This policy fundamentally misunderstands how home infusion is delivered, could jeopardize patient safety and creates barriers that have already inhibited patient access to these services,” said Logan Davis, PharmD, chairman of NHIA’s board of directors. The association has pushed CMS to revise the policy, finalized last year, and even filed a lawsuit in federal court earlier this year. The proposed rule would group home infusion drugs into three payment categories in preparation for the new home infusion benefit that starts in 2021. Each category would have a single unit of payment in accordance with specified infusion codes under the physician fee schedule. In the rule, CMS also proposed higher payment amounts for the first home infusion therapy visit, along with a small decrease in the payment amounts for each subsequent visit to make the adjustments budget neutral. The 21st Century Cures Act, passed in 2016, requires Medicare to pay for home infusion services associated with Part B infusion drugs.