This bill makes it easier for Medicare patients to get certain infusion treatments at home. It would have Medicare cover external infusion pumps, the drugs used with them, and related supplies when the medicine must be given by or under a health professional’s supervision and is provided safely at the patient’s home by a qualified home infusion supplier. It also requires clear notices to patients about what they would pay if they choose home infusion versus getting the same drug in another setting.

Coverage would start in the first calendar quarter that begins at least one year after the law takes effect. To qualify, the drug’s FDA instructions must say it needs professional supervision and call for at least 12 infusions per year (by IV or under the skin), or the infusion rate must require an external pump, as determined by the Secretary of Health and Human Services.

Key points

• Who is affected: Medicare patients who need regular infusion drugs at home; qualified home infusion therapy suppliers.
• What changes: Medicare would cover external infusion pumps, certain home infusion drugs that aren’t self-administered, and related supplies when professional supervision and home-based care standards are met; patients must be told about cost sharing for home care versus other settings.
• When: Begins the first calendar quarter at least one year after the law is enacted.