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Judge dismisses home infusion lawsuit

Judge dismisses home infusion lawsuit

Connie SullivanALEXANDRIA, Va. - A U.S. district court has dismissed a lawsuit filed by the National Home Infusion Association over the implementation of a Medicare home infusion therapy services benefit for a “lack of subject matter jurisdiction.” 

The lawsuit, filed in 2019 against the Department of Health and Human Services, argued that a final rule published in November 2018 that limits reimbursement for professional services to only those days a “skilled professional is in the home,” ignores congressional intent.  

Judge Timothy J. Kelly dismissed the case on the grounds that the court’s jurisdiction over Medicare is limited and that, in most cases, challengers must complete HHS’s four-step appeal and review process prior to filing with the court, according to NHIA. 

The association countered that the multi-year administrative process would have been futile considering the two-year duration of the benefit. 

“It’s frustrating and disappointing that this case was dismissed on a technicality and not considered on its merits,” said Connie Sullivan, BSPharm, NHIA’s CEO. “We still believe that CMS’s implementation is inconsistent with Congress’ intent and over the past two years, we have seen—and documented—how the agency’s actions have negatively impacted patient access to home infusion therapy. This ruling reaffirms the need for Congress to enact clarifying legislation.”



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