DME Home Infusion Law Passes

WASHINGTON—The 2026 health funding bill that was signed into law Feb. 3 included a change to the qualifying criteria for drugs under Medicare’s home infusion benefit that may expand access to some drugs if an infusion pump is required for administration.

According to the National Home Infusion Association, passage the Joe Fiandra Access to Home Infusion Act (HR 4993) reflects Congress’ recognition of the strong patient interest—including among individuals with rare diseases—in home infusion access.
NHIA has been urging—and gotten bipartisan support for—the Preserving Patient Access to Home Infusion Act (HR 2172), which would remove barriers to accessing home infusion by establishing coverage for the full scope of professional services that make the benefit function and allow access for patients needing intravenous anti-infectives, with or without the use of an infusion pump.

The Joe Fiandra Access to Home Infusion Act that passed creates a path to coverage under Medicare’s durable medical equipment,  prosthetics, orthotics and supplies (DMEPOS) benefit for a subset of drugs that require a health care provider and an infusion pump for administration. 

Rep. Brian Fitzpatrick introduced the law, named in honor of Army veteran Joe Fiandra, who died in 2022 of amyloidosis.

“Joe Fiandra served our nation with honor, loved his family fiercely, and faced his illness with courage,”  Fitzpatrick said in a release celebrating the bill’s passage. “But his fight revealed a health care system that made an already difficult moment even harder. When I met with Joe’s wife, Helen, she asked for one thing—that no other family would have to endure the same struggle. Now, with the signing of this bill, that promise has become law. Joe Fiandra’s legacy will permanently strengthen how Medicare delivers care—putting patients first and removing barriers that never should have existed.”

But there is still ground to cover. As NHIA explained in a release, the current DMEPOS home infusion benefit is limited to about 40 drugs and lacks payment for pharmacy services, which has limited provider participation in the program. By comparison, all other payers use a bundled payment model to cover all services and supplies and allow access to more than 300 infusion drugs without restrictions for the use of a pump or a limitation on payments for services unless they are delivered face to face.

NHIA called on Congress to continue work on expanding home infusion access and to urgently pass the Preserving Patient Access to Home Infusion Act. 

“I am encouraged by the momentum in Congress to address the limited access to home infusion that exists for Medicare patients. For too long, Medicare has lagged other payors that have recognized the benefits of offering straightforward access to home infusion rather than directing patients to higher-cost settings for infusions. Congress needs to take the next step and pass H.R. 2172 and finally establish a benefit that reflects how care is actually delivered,” said NHIA President and CEO Connie Sullivan. “We are ready to support Congress in their efforts to finally fix the broken Medicare home infusion benefit.”