HB2172, titled the Preserving Patient Access to Home Infusion Act, would amend the Medicare statute to clarify and expand coverage rules for home infusion therapy. The bill updates the definition of home infusion therapy to include pharmacy services and related activities such as assessments, drug preparation and compounding, and care coordination/documentation. It also allows nurse practitioners and physician assistants, in addition to physicians, to establish and review a home infusion plan of care.
The bill further revises Medicare payment rules for home infusion services beginning January 1, 2026. It changes how the daily payment amount is calculated, creates a transitional payment rule from 2026 through 2029, and reduces payment by 50 percent when a qualified supplier is not physically present in the patient’s home on the day the drug is administered. It also expands access for certain non-pump intravenous antibacterial, antifungal, and antiviral drugs by clarifying that home infusion billing can still occur even when the drug itself is not separately payable under Medicare. In addition, it bars separate Medicare payment for certain infusion supplies—such as tubing, catheters, dressings, needles, and syringes—when they are furnished on the same day in conjunction with covered home infusion therapy.
Impact
The bill would amend sections of title XVIII of the Social Security Act governing home infusion therapy and Medicare Part B payment. It would broaden who can establish and review infusion care plans, redefine covered home infusion-related services, adjust supplier payment methodology, and limit duplicate payment for supplies already associated with home infusion therapy. The practical effect would be to preserve and potentially expand Medicare beneficiaries’ access to home infusion services while changing reimbursement rules for suppliers and related billing practices.
Sentiment
Based on the bill’s title, bipartisan sponsorship, and lack of recorded opposition in the provided materials, the overall sentiment appears supportive and patient-access oriented. The measure is framed as a clarification of congressional intent and a preservation of existing access rather than a major policy overhaul. No committee debate or vote history was provided, so there is no evidence here of formal controversy or partisan division.
Contention
The main policy tension appears to be between preserving patient access to home infusion therapy and controlling Medicare spending or payment duplication. Potential points of contention include the new 50 percent payment rule when a supplier is not physically present, the transitional payment methodology through 2029, and the prohibition on separate payment for certain supplies when bundled with home infusion services. Suppliers, Medicare administrators, and patient advocates could differ on whether these changes adequately support home-based care while maintaining appropriate reimbursement.