Health care bills, including one concerning home infusion therapy, were considered during a hearing by the Energy and Commerce Subcommittee on Health in the House of Representatives in July.
The Medicare Part B Home Infusion Services Temporary Transitional Payment Act, “is a bill worthy of our support,” Rep. Gene Green, D-Texas told the committee. “The timing and payment changes for drugs and services do not line up, potentially resulting in reduced patient access. This bill solves the problem by providing a temporary bridge from 2019 to 2021, so patients don’t lose access to the care they need.”
The House of Representatives has since passed the Medicare Part B Improvement Act of 2017, which includes the temporary transitional home infusion legislation. The bill accelerates the implementation of Medicare payment for home infusion services to January 2019, two years earlier than the start date established in last year’s Cures bill.
Other provisions in the bill would extend the Medicare Intravenous Immune Globulin (IVIG) Demonstration Project through the end of 2020. This is a study by Medicare to evaluate the benefits of providing reimbursement for home infusion treatment using intravenous immunoglobulin for immune deficiency disease.
These developments are good news for patients suffering from conditions requiring home infusion therapies.
Infusion Drugs and Pharmacies
Infusion drugs are typically costly medications that require special handling and administration, and home infusion therapy has arisen as a way to reduce the cost of these treatments by performing infusion in patients’ homes instead of hospitals or outpatient facilities.
Specialty pharmacies are typically responsible for receiving, storing, compounding, administering the medications. Many also offer education, training and other support services for patients to foster proper administration. Because the drugs are costly, and the conditions that they treat are serious, medication that is wasted due to misuse or improper storage can be financially and medically harmful.
“Commercial insurers, Medicaid programs, and many Medicare Advantage health plans currently recognize that infusion therapy delivered at home is a cost-effective, low risk, and clinically effective treatment option,” Rep. Green said. “The community supports an explicit payment for home infusion clinical services that are required to ensure effective patient care.”
Specialty pharmacies with home infusion services offer personalized, hands-on service to patients and caregivers. The staff performs a comprehensive intake and assessment procedure to understand the patient’s medical history, other medications, assess the patient’s ability to tolerate the catheter used for infusion, any conditions at the home that would put the patient at risk, and more. These steps are important to avoid any medication interactions with other drugs, and to make sure that the drugs are stored and handled as required.
Home infusion pharmacies also provide ongoing services such as phone support, patient monitoring, and any testing that may be required. Most have a trained, dedicated nursing staff that performs home visits and can communicate with family and caregivers.