The Medicare Home Infusion Therapy Coverage Act of 2009, H.R. 574, Would Close Medicare Gaps and Save Money

Washington, D.C.-- Congressman Eliot Engel re-introduced his legislation to improve coverage of home infusion therapy in Medicare, H.R. 574, a move that will save money by allowing more procedures to be done at home rather than in more expensive hospitals or nursing home settings.

Rep. Engel said, “Patients needing intravenous medication, or medication administered into the spinal cord or muscular tissue should be allowed to get treatment in the comfort of their homes. These often include cancer patients and people with congestive heart failure."

Rep. Engel, a senior member of the Health Subcommittee of the Energy and Commerce Committee, said the approach of the bill was simple. It would institute coverage for the home infusion-related services, supplies and equipment under Medicare Part B, while maintaining coverage of the drugs themselves under Medicare Part D. In addition, the Department of Health and Human Services would apply quality standards that are consistent with the private sector’s community standard of care.

While Medicare Part D drug benefit covers the cost most home infusion drugs, Medicare does not pay for the services, supplies and equipment necessary for the safe administration of the drugs. Because most people cannot afford these costs, they are forced to go to hospitals and nursing homes for treatment, where it is far most costly than that done at home. “This can be a great inconvenience to patients, especially those living in rural areas and those who rely on public transportation. We can do better for patients and for the Medicare program,” added Rep. Engel.

For decades, private health plans have done infusion therapy successfully and cost-effectively by providing treatment in the patient’s home. Home infusion also prevents patients from being at risk for hospital based infections. According to Rep. Engel, "The current Medicare coverage for home infusion therapy is both illogical and incomplete. My Medicare Home Infusion Therapy Coverage Act will give Medicare beneficiaries the same access to home infusion therapy as enjoyed by private sector patients.

“Both patients and the Medicare program itself would reap the benefits of broader access to these important medical treatments in the home,” said Rep. Engel. “It would also result in a much-needed relief to our taxpayers by reducing the costs to our nation’s healthcare system.”

The bill is strongly supported by a broad coalition of patient organizations, infusion pharmacies, infectious disease physicians, and manufacturers of infusion drugs. Due to other business facing the previous Congress, no vote was held on this legislation and it was not considered before the close of the 110th Congress

The “The Medicare Home Infusion Therapy Coverage Act of 2009 is also co-sponsored by Reps. Tim Murphy, (R-PA), Tammy Baldwin, (D-WI), and Kay Granger (R-TX). It is sponsored in the Senate (S.254) by Sen. Blanche Lincoln (D-AR), Sen. Olympia Snowe (R-ME), and Sen. Johnny Isakson (R-GA). It was referred to the House Energy & Commerce and House Ways & Means Committees.