NHIA raises concerns about infusion therapy and competitive bidding

The National Home Infusion Association (NHIA) has urged the Centers for Medicare & Medicaid Services (CMS) to reconsider its decision to include certain home infusion therapies in the Competitive Bidding Program’s re-compete for Round 1 contracts.

The association pointed out that it is common for infusion patients to need more than one therapy—with some covered by Part B and others covered by Part D. That may force some patients to split providers under competitive bidding, which only covers Part B therapy.

“The Medicare program should avoid the illogical situation where it is encouraging infusion pharmacies to participate in Part D for the provision of home infusion therapy, while limiting their participation in Part B for the provision of other home infusion therapies,” Mary Ann Cope, president, HomeChoice Partners, Inc. and NHIA board chair, said in a press release.

Moreover, Congress is now considering legislation to create a comprehensive and coordinated home infusion therapy benefit under Medicare. Subjecting home infusion therapy to competitive bidding would complicate Medicare reimbursement for an area with complex, unresolved issues, the association said.

NHIA represents the more than 400 independent local and regional home infusion pharmacies; national home infusion providers; and hospital-based home infusion organizations that provide services to more than a million patients a year in their homes or outpatient settings.