Measure Would Consolidate Infusion Under Medicare Part B

Washington

Legislation recently proposed by Rep. Kay Granger, R-Texas, would consolidate coverage for home infusion drugs and services under Medicare Part B.

The Medicare Home Infusion Consolidated Coverage Act (H.R. 5791) would bring all components of home infusion therapy under the Medicare Part B DME benefit for external infusion pumps, including supplies, drugs, equipment and professional services.

Only 23 infusion drugs are now covered under Part B, with the rest under the new Part D benefit, which includes a small dispensing fee. Services and supplies that go along with home infusion therapy are not covered by Part B or D.

“This bill will enable thousands of beneficiaries to obtain these often life-saving therapies in the most convenient and cost-effective setting — their homes,” Rep. Eliot Engel, D-N.Y., a co-sponsor of the bill, said in a statement.

Engel continued, “Patients with private health coverage have been able to receive this treatment for 20 years with excellent results and fewer costs; it is time that Medicare provide this same option.”

Under current Medicare coverage rules, beneficiaries are often needlessly admitted into hospitals or nursing homes to receive the care in situations where home infusion would be preferred, he said.

“For most patients, receiving this safe and effective treatment at home is preferable to inpatient care in terms of convenience, comfort and cost.”