Advocates Speak Out on CMS Infusion Access Rule

ALEXANDRIA, Virginia—In its proposed home health payment rule released last week, the Centers for Medicare & Medicaid Services (CMS) included changes to home infusion therapies that advocates say is a positive step but not a solution to the broader challenges facing home infusion in Medicare.

The rules include details on the implementation of the Joe Fiandra Access to Home Infusion Act. The Fiandra legislation was enacted earlier in 2026 to expand Medicare coverage for a narrow subset of home infusion therapies that require both an external infusion pump and administration by a health care professional. 

 National Home Infusion Association (NHIA) said the proposal should not be viewed as a solution to the broader access challenges facing beneficiaries who would rather receive their infusions at home.

“The overwhelming majority of Medicare beneficiaries continue to lack meaningful access to home infusion because of fundamental flaws in the Medicare home infusion benefit,” NHIA said. “As a result, thousands of beneficiaries receiving intravenous anti-infectives, hydration, immune globulin, biologics and other infused medications continue to be directed to hospital outpatient departments and skilled nursing facilities despite home infusion often being the clinically appropriate, lower-cost and patient-preferred setting.”

The organization said it urges Congress to enact the Preserving Patient Access to Home Infusion Act (HR 2172, S1058) to more fully address the disparity in access between Medicare and commercial coverage. The legislation would address the structural deficiencies in the Medicare home infusion benefit by ensuring beneficiaries can receive the professional services necessary to safely administer infused medications in their homes.

“Passage of this legislation would substantially expand access, improve patient choice, reduce unnecessary utilization of higher-cost sites of care and better align Medicare policy with today’s clinical standards,” NHIA said.

NHIA said it looks forward to continuing to work with CMS and Congress to ensure that all Medicare beneficiaries—not just the small number affected by this proposal—have access to safe, high-quality home infusion services when clinically appropriate.