Home Infusion Bill Introduced in the House

WASHINGTON–Bipartisan legislation introduced June 5 by Rep.
Eliot Engel, D-N.Y., would extend coverage for home infusion
services to Medicare beneficiaries, a benefit currently available
to most patients in the private sector.

The “Home Infusion Therapy Medicare Coverage Act of 2007” (H.R.
2567) would give home infusion services and supplies coverage under
Part B, with drugs covered under Part D. The measure is a revised
version of a bill co-sponsored by Engel last year that would have
consolidated both the drugs and services under Part B (see HomeCare Monday, July 24, 2006).

When Congress passed the Medicare Modernization Act in 2003,
lawmakers added coverage for home infusion drugs including
antibiotics, antivirals and antifungal drugs, which are prescribed
for patients with serious infections such as bone and skin
infections, heart infections, pneumonia and urinary tract
infections.

“Congress correctly understood what many private payers have
realized for decades–that a home infusion therapy benefit under
Medicare would reduce hospital stays and decrease costs,” said
Donald M. Poretz, MD, president-elect of the Infectious Diseases
Society of America.

But IDSA said CMS interpreted the law to cover only the drugs
but not the services and supplies associated with home infusion.
“As a result, my Medicare patients must come to my office, stay in
the hospital or live in a nursing home to receive antimicrobial
infusion services,” said Poertz, whose organization is urging
support for the new bill.

The National Home Infusion Association also hailed the bill’s
introduction, saying that H.R. 2567 “would close a glaring and
unintended gap in Medicare drug coverage that is affecting the
sickest, most vulnerable patients.” The group also pointed to the
efficiencies of home infusion. It costs less, produces better
results and does not carry the risk of hospital-acquired
infections, NHIA said.

“For decades, commercial health plans have treated these
individuals successfully and in a cost-effective manner by
providing coverage for infusion therapies administered in the
patient’s home,” Engel said, adding that professional services,
supplies and equipment “are integral components of this
therapy.”

Said Engel, “Medicare is virtually the only payer in the country
where home infusion therapy is not adequately covered. Our seniors
deserve better.”

Co-sponsors of the bill include Reps. Kay Granger, R-Texas;
Tammy Baldwin, D-Wisc.; Chip Pickering, R-Miss.; Randy Kuhl,
R-N.Y.; and John Tierney, D-Mass. The bill was referred to the
Energy and Commerce and Ways and Means committees.