CMS Confirms Home Infusion Providers Not Target of Fraud Demo

WASHINGTON–After asking CMS for a clarification of the
“infusion providers” targeted under a recently announced fraud
demonstration program, the National Home Infusion Association got
the answer it wanted: Home infusion therapy providers are not
included.

On Aug. 20, the Department of Health and Human Services, CMS and
the Department of Justice announced a two-year demonstration
program designed to remove criminal and fraudulent “infusion
providers” from the Medicare program.

However, the NHIA said, “the infusion providers in question were
not clearly described in the written materials released to the
public, and numerous observers assumed that CMS was referring to
home infusion therapy providers.” The association asked CMS for “an
immediate and public clarification” of whether home infusion
therapy providers were implicated in the planned demonstration
program. (See
HomeCare Monday, Aug. 27.)

In response, CMS amended a fact sheet making it clear that the
demonstration program does not involve providers who offer infusion
in the home setting. Rather, it will be limited to clinics and solo
practitioners in South Florida providing intravenous infusion
therapy and/or intramuscular and subcutaneous injections in the
office setting only.

“We commend CMS for responding quickly to clarify that home
infusion therapy providers are not involved in this demonstration
program,” said Russell Bodoff, NHIA executive director, in a press
release about the clarification. The release also said NHIA
“strongly supports the passage of H.R. 2567, the Medicare Home
Infusion Therapy Coverage Act of 2007, which would provide for
meaningful coverage of home infusion therapy, as well as the
development of essential quality standards.”

View the revised fact sheet on the
infusion therapy fraud demonstration.