Pennsylvania governor deals setback to infusion providers

Sunday, November 19, 2006

HARRISBURGH, Pa. - Pennsylvania Gov. Edward Rendell vetoed a bill Nov. 9 that would have allowed home infusion providers to bill for pharmacy-related services provided to the state's Medicaid patients.

The bill, H.B. 2202, would have defined the home infusion therapy benefit separately from retail pharmacy, allowing medical assistance payments for infusion pharmacy services, including dispensing medication, supplies and equipment.

The bill had passed unanimously through both the Pennsylvania House and Senate.

"It wasn't unexpected but we were on such a high that we thought, 'How can he veto it?'" said Helen Michener, general manager of Critical Care Systems in Harrisburg, Pa.

In written comments explaining the decision, Gov. Rendell wrote: "The Commonwealth covers the cost of the drugs and the cost of the nurse to come to the home to assist the patient and monitor the therapy."

However, without payment for related pharmacy services, affected beneficiaries may have to remain in a hospital or nursing home, said Dave Fiorini, executive director of the Pennsylvania Association of Medical Suppliers.

"They're creating an atmosphere where a patient who is on this type of therapy would be receiving it in institutional care when they can receive at home--a less-costly alternative," said Fiorini.

Michener said the industry would continue to work with the state but said there was no plan of action in place.