Preserving Patient Access to Home Infusion Act

This bill aims to keep Medicare patients’ access to home infusion therapy at home. It clarifies that pharmacy services are part of the home infusion benefit. It updates how Medicare pays: from January 1, 2026 through December 31, 2029, payments are set to reflect up to 5 hours of infusion in a single day, and if a qualified supplier isn’t physically in the home that day, payment for that day’s services is 50% of the usual amount. It also lets nurse practitioners and physician assistants, not just doctors, set and review a patient’s home infusion plan of care starting in 2026.

The bill expands access for medicines given without a pump and makes billing clearer. It says the professional services tied to these non‑pump drugs or biologics can be paid by Medicare even if the drug itself isn’t payable by Medicare, starting in 2026. At the same time, it stops separate same‑day payments for certain supplies (like tubing, catheters, dressings, needles, syringes under HCPCS A4221, A4222, K0552) when Medicare already pays for that day’s home infusion therapy for the same drug, beginning January 1, 2026.

• Who is affected: People on Medicare who get IV or similar treatments at home; home infusion suppliers; nurses, pharmacists; nurse practitioners and physician assistants who manage care plans.
• What changes: Clearer coverage of pharmacy services; updated payment rules (including the 5‑hour daily payment assumption and a 50% rate if no in‑home presence); permission for NPs and PAs to manage plans; billing allowed for services tied to non‑pump drugs; no double payment for certain supplies on the same day as paid home infusion therapy .
• When: Most changes apply to items and services furnished on or after January 1, 2026; the 5‑hour daily payment policy runs through December 31, 2029 .