Medicare Home Infusion Legislation

Call to Action: Ask Congress to Support Medicare Coverage for Home Infusion Therapy

As odd as it may seem, Medicare does not cover all medical services patients might need.   If you have been on Medicare for a while, you may have already experienced this fact, especially if you needed Home Infusion Therapy.

Home Infusion Therapy is a pharmacy and nursing service which allows people to receive intravenous therapy in the comfort of their home. Medications are prescribed by your physician and the infusion pharmacy and nursing provider will coordinate care with you and your clinical team.  Standard therapies might include antibiotics, hydration, pain management and nutritional therapies.

Some therapies are covered under the Part B DME benefit, a result of a decision by Medicare over 30 years ago to include these few therapies in the durable medical benefit; not a good fit.

Are these the best available options for you?

However, unless you have a secondary insurance or can pay out-of-pocket for your IV therapy, you only have a few options.  Option 1, you can go to a skilled nursing facility or Option 2, you can go into the hospital outpatient department or doctor’s office for every dose.

For most folks, those options are hardly convenient or cost-effective compared to having your therapy at home. Even more confusing is that commercial insurance plans, other federal government plans (VA, TriCare) and even most state Medicaid plans cover IV therapy at home.

Are you concerned yet?  Outraged?

Medicare Home Infusion Site of Care Act

For a few years now, the home infusion provider sector has been working on passing legislation at the federal level to correct this gap in coverage for seniors.  Currently, there is a bill pending in both the House and the Senate and our National Home Infusion Association (NHIA) has been spearheading the efforts to educate our representatives in congress about the issue so that they can pass the bill telling Medicare to create a coverage benefit.

This is a great time for all of us to contact our Senators and Representatives to ask them to support this bill known as the “Medicare Home Infusion Site of Care Act” and assigned to the House of Representatives as H.R. 605 and to the Senate as S. 275.

I have met personally with offices of our Montana Senators, Steve Daines and Jon Tester, and the advisory committee for our at–large Representative, Ryan Zinke.  I have asked them all to show their support for Medicare patients and the Medicare program by supporting the bill and signing on as co-sponsors.

To date, they have not taken that final step, unfortunately.

Take Action and Contact a Legislator

If you are concerned about this lack of coverage, contact our legislators and tell them.  For more information, go to the NHIA resource page which includes instructions about how to call, email or mail them.

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You can also contact me, Dave Grady, at Big Sky IV Care, to discuss the issue further.   Don’t wait until you need IV therapy at home, let’s pass this much needed legislation this year!

Dave Grady

Big Sky IV Care

[email protected]