Home infusion: Stakeholders arm themselves with data

“We are looking at any and all avenues’
Friday, September 26, 2014

WASHINGTON – The stars could align for the latest iteration of a bill to require Medicare to cover home infusion therapy, say industry stakeholders.

Similar bills have been introduced over the past several years, but stakeholders have a few things working in their favor this year. The first: a new study by Avalere, a non-partisan healthcare policy firm, that found Medicare could save $80 million over a 10-year period if it covers home infusion therapy. The National Home Infusion Association (NHIA) commissioned the study at the behest of lawmakers.

“It’s never been a question of convincing congressional staff members that this is valuable,” said Russ Bodoff, executive director of NHIA. “I think everyone accepts that home infusion is a valuable service. The question always was, ‘Is it a savings or is it a cost?’ Now there’s data.”

Reps. Eliot Engel, D-N.Y., and Pat Tiberi, R-Ohio, introduced The Medicare Home Infusion Site of Care Act on Sept. 10. The bill would require Medicare to pay for home infusion services and related supplies under Medicare Part B. The drugs are already covered under Part D. 

The second thing working in the industry’s favor: a growing recognition of the potential of the post-acute care market to not only reduce costs but also increase the quality of care.

“Patient care is getting more and more important and what the appropriate site of care is seems to be something that’s right up Congress’ alley right now,” said Ken Van Pool, vice president of legislative affairs for NHIA.

With the current legislative session rapidly winding down, stakeholders are focusing on building a coalition of support around the bill to get it attached to a larger vehicle.

“It doesn’t look like there’s going to be a lame duck doc fix or Medicare bill, but if there is, we want to be prepared for that,” Van Pool said. “Longer term, there are several vehicles that will move. We are looking at any and all avenues.”