Section 1 Short title
This Act may be cited as the “Preserving Patient Access to Home Infusion Act”.
Preserving Patient Access to Home Infusion Act
A BILL
To amend title XVIII of the Social Security Act to clarify congressional intent and preserve patient access to home infusion therapy under the Medicare program, and for other purposes.
Sec. 2 Preservation of patient access to home infusion therapy under Medicare program
Inclusion of pharmacy services— Section 1861(iii)(2) of the Social Security Act (42 U.S.C. 1395x(iii)(2)) is amended—
in subparagraph (A), by inserting “and pharmacy services” after “nursing services”; and
in subparagraph (B), by inserting “, assessments, drug preparation and compounding, coordination and documentation of infusion therapy services in the plan of care” after “subsection (n))”.
in clause (i), by striking “clause (iii)” and inserting “clauses (iii) and (iv)”;
in clause (ii) by inserting after the first sentence the following new sentence: “For purposes of the previous sentence, a reference to payment to a qualified home infusion therapy supplier for an infusion drug administration calendar day in the home of such individual shall refer to payment for each day on which such a drug was administered to the individual (regardless of whether a qualified home infusion therapy supplier was physically present in the home of such individual on such date).”; and
by adding at the end the following new clause:
“(iv) Special rule when a qualified home infusion therapy supplier not physically present in the individual's home—In the case where a qualified home infusion therapy supplier is not physically present in the individual's home on the day the home infusion drug is administered to the individual, the single payment amount under this subsection for items and services described in clause (i) furnished on such day to such individual shall be an amount equal to 50 percent of the amount that would have applied under this subsection for such items and services if such a supplier had been physically present.”
Permitting nurse practitioners and physician assistants To establish and review a home infusion plan of care— Section 1861(iii)(1)(B) of the Social Security Act (42 U.S.C. 1395x(iii)(1)(B)) is amended by striking “physician (as defined in subsection (r)(1)) and is periodically reviewed by a physician” and inserting “physician (as defined in subsection (r)(1)) or a nurse practitioner or physician assistant (as those terms are defined in subsection (aa)(5)) and is periodically reviewed by a physician, nurse practitioner, or physician assistant”.
Effective date— The amendments made by this section shall apply with respect to items and services furnished on or after January 1, 2024.