WASHINGTON--Sens. Blanche Lincoln, D-Ark, and Olympia Snowe, R-Maine, introduced a bill last week that would provide coverage for infusion-related services, supplies and equipment under Medicare Part B while leaving coverage of the drugs used in infusions under Part D.
The Medicare Home Infusion Therapy Coverage Act of 2008 (S. 3505) would close a gap in coverage “that nearly everyone--patients, physicians, caregivers, infusion pharmacists, nurses and even CMS--agrees needs to be fixed,” according to a press release from the National Home Infusion Association.
Infusion therapy involves the administration of medication through a needle or catheter, and is prescribed for many serious diseases when only infusible drugs are appropriate treatment, the NHIA said. Diseases commonly requiring infusion therapy include infections unresponsive to oral antibiotics, cancer and cancer-related pain, dehydration, gastrointestinal diseases or disorders that prevent normal functioning of the gastrointestinal system, congestive heart failure, Crohn's disease, hemophilia, immune deficiencies, multiple sclerosis, rheumatoid arthritis and more.
“Private insurers have been covering home infusion therapy for decades because they recognize that being treated at home is safer, more convenient, better for patients and is less costly,” said Russ Bodoff, NHIA’s executive director. “It is good for patients and it is good medical practice.”
But until now, Medicare has tended to cover the drugs and biologics used in infusions but not the medical services, supplies or equipment needed to deliver the home therapy. As a result, Medicare patients have had to enter a hospital or nursing home for the infusion treatment to be covered by their Medicare insurance.
“Home infusion therapy is covered by private insurers because they see the tremendous value, and Medicare beneficiaries deserve no less,” said Lincoln. “I urge my colleagues in the Senate to support this legislation, which would lower costs and improve the quality of life for patients who want to have access to these therapies in their homes. In fact, this is really the direction we need to take throughout the American health care system. We need a system that is efficient, geared toward the real needs of individual patients and cost effective.”
Snowe noted the legislation would simultaneously reduce costs to Medicare while improving care for older Americans. “Unnecessary institutional treatment simply makes no sense when patients can be treated in the comfort of their home--and at lower cost to Medicare,” she said.
John Magnuson, NHIA vice president of legislative affairs, noted that “Home infusion therapy offers many patients the freedom to be treated where they work and live. Congress needs to act now so that older people today and the large number of baby boomers tomorrow can receive care at home, and do not need to face the risks and discomforts of institutional care.”
The bill has been referred to the Senate Finance Committee.