Infusion bill gains ground

Friday, October 31, 2008

A bill that would provide Medicare Part B coverage for home infusion therapy was introduced in the Senate Sept. 17.

Introduced by Sens. Olympia Snowe, R-Maine, and Blanche Lincoln, D-Ark., the Medicare Home Infusion Therapy Coverage Act of 2008 would pay for services, supplies and equipment related to home infusion therapy under Medicare Part B. It pays for home infusion drugs under Part D.

“We believe this is the most appropriate way to do this,” said Russ Bodoff, executive director of the National Home Infusion Association (NHIA). “The infusion pharmacist plays an important role in managing the care of the patient and it’s extremely difficult for the pharmacy if half of what they do is not reimbursed.”
Patients who require home infusion therapy and who lack insurance coverage wind up in hospitals or nursing homes, supporters say. Medicare pays for the treatment under its Part A benefit, but it’s a far more expensive alternative.

The average cost to provide infusion therapy per day: $200 in the home; $300 in a skilled nursing facility; and $1,200 in a hospital, said John Magnuson, vice president of clinical affairs for NHIA. The potential for better patient outcomes also needs to be considered, he said.

“There is less opportunity for infections in the home, which creates fewer costs,” he said. “A lot of these folks have lowered immune systems and a higher possibility of acquiring infections than the average patient.”

The new bill mirrors legislation introduced in the House of Representatives in June 2007

“As lawmakers understand the issue, it becomes a common sense issue,” said Bodoff. “It’s cheaper to treat people in the home than in the hospital.”