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Tell Congress: Pass the Preserving Patient Access to Home Infusion Act!

In 2016, Congress passed the 21st Century Cures Act, which included reforms to the Medicare Part B DMEPOS program including changing the payment methodology for drugs from Average Wholesale Price to Average Sales Price. To ensure home infusion services were not interrupted, Congress added a new Home Infusion Therapy Services benefit to Medicare Part B. Since the new benefit created by Cures did not start until 2021, Congress included a home infusion services temporary, "transitional" benefit in the Bipartisan Budget Act of 2018 to bridge the gap until the "permanent" benefit began. 

Unfortunately, despite the stated intent of Congress, CMS has interpreted the new home infusion therapy services benefit as a nursing-only service. This interpretation limits reimbursement to days when nurses are physically present in the patient's home, rather than the standard per diem reimbursement used by commercial payers for days medication is infused, and fails to account for essential services that home infusion providers furnish remotely. Despite multiple letters from the congressional sponsors of the home infusion legislation, numerous comments through the rule-making process, and drops in utilization, CMS has not moved from their flawed definition of “home infusion calendar day.” 

Please join NHIA in urging Congress to pass legislation as part of the final legislative package of 2021, to permanently fix the home infusion therapy services benefit. To facilitate your outreach, we have drafted a sample letter to communicate the need for action to your Representatives and Senators. Please customize the sample letter below, or craft your own message to share a personal story about the importance of home infusion services for America's seniors. 

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