NHIA to CMS: Don’t ‘shortchange’ home infusion

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Tuesday, October 30, 2018

WASHINGTON – With a final rule not expected until November, industry stakeholders continue to press CMS for changes to provisions related to home infusion.

Board members of the National Home Infusion Association and others met with Demitrios Kouzoukas, principal deputy administrator of CMS and director of the Center for Medicare, on Sept. 17 to urge the agency to strike a provision that would require that a nurse be present in the home the day an infusion drug is administered.

“To the extent that CMS is trying to save money by shortchanging home infusion, that would be penny wise and pound foolish,” said Sharon Pearce, vice president of government affairs for NHIA. “Without access to home infusion (in the home), these patients would wind up in costlier settings like hospitals and nursing homes.”

Stakeholders also urged CMS to adopt an expanded definition of home infusion professional services, said Pearce.

“It’s hard to know if we are getting though,” she said. “Mr. Kouzokas seemed sympathetic, but he might be hamstrung by budgetary restraints.”

To also apply congressional pressure on CMS, Reps. Kenny Marchant, R-Texas, Eliot Engel, D-N.Y., Fred Upton, R-Mich., and Terry Sewell, D-Ala., in September sent CMS Administrator Seema Verma a letter urging CMS to allow payment for each calendar day that home infusion occurs, and to adopt a more comprehensive definition of professional services. THe letter had 20 signatures. A similar letter in the Senate, spearheaded by Sens. Johnny Isakson, R-Ga., and Senator Mark Warner, D-Va., garnered 21 signatures.

“They’ve made their concerns known,” said Pearce. “We are hopeful that when CMS sees that it’s clear this is what Congress intended when they created this benefit, that they’ll be able to adjust it.”