ALEXANDRIA, Va. (February 15, 2019)—The National Home Infusion Association (NHIA) filed a lawsuit against the U.S. Department of Health & Human Services (HHS) over a misguided policy determination that could significantly reduce patients’ access to home infusion therapy services.
At issue is the Centers for Medicare & Medicaid Services’ (CMS) Home Infusion Final Rule, issued November 13, 2018, which limits home infusion professional services reimbursement only to those days in which a “skilled professional is in the patient’s home.” The final rule implements temporary transitional payments for home infusion therapy services for calendar years 2019 and 2020; these payments are required by section 50401 of the Bipartisan Budget Act of 2018. CMS’s interpretation effectively eliminates reimbursement for pharmacists’ and other professional services that are performed remotely.
“This rule undercuts Congress’s intent to ensure that Medicare beneficiaries can access these therapies in the safety and comfort of their own homes,” said Varner Richards, PharmD, chair of the NHIA Board of Directors and a home infusion pharmacist from Columbia, South Carolina. “It simply doesn’t reflect the reality of how home infusion services are currently delivered and reimbursed.”
“For the past several months, the association and its members have made numerous legal, policy and political arguments imploring CMS to modify the regulations to align with Congress’s intent in the 21st Century Cures Act and Bipartisan Budget Act of 2018,” explains Connie Sullivan, BSPharm, NHIA president and CEO. “We believe the agency violated the statute and have concluded that legal action is our only recourse for protecting the interests of our members and access to services by Medicare beneficiaries.”
For more information and a copy of the claim, click here.
