Preserving Patient Access to Home Infusion Act

Expanded Role for Care Providers: Under Section 2(c), nurse practitioners and physician assistants are permitted to establish and review a home infusion plan of care, which was previously limited to physicians. This allows more qualified professionals to manage a patient's care plan.

Payment for Remote Administration: Section 2(b)(2) ensures that a qualified home infusion therapy supplier can receive payment for an infusion drug administration day regardless of whether the supplier was physically present in the home of the individual on that date.

Clarification of Pharmacy Services: Section 2(a) includes pharmacy services, assessments, drug preparation, and compounding within the definition of home infusion services. This clarifies what is included in the care provided to patients.

Transitional Payment Rule: Section 2(b)(3)(B)(II) includes a transitional rule for home infusion therapy furnished between January 1, 2026, and January 1, 2030, ensuring the single payment amount reflects 5 hours of infusion for a particular therapy in a calendar day.

Access to Non-Pump Drugs: Section 3(a) and 3(b) address drugs or biologicals, such as antibacterials, antifungals, or antivirals, that are administered intravenously without a pump that is considered durable medical equipment. This clarification helps ensure payment for items and services coordinated with these drugs.

Reduced Payment for Non-Present Suppliers: According to Section 2(b)(4), if a qualified home infusion therapy supplier is not physically present in the individual's home on the day a drug is administered, the single payment amount for items and services is limited to 50 percent of the amount that would have applied if the supplier had been present.

Restrictions on Supplies Payment: Section 4(a) states that no payment may be made under certain provisions for applicable items and services—such as tubing, catheters, dressings, needles, and syringes—when they are furnished in conjunction with home infusion therapy on the same day and for the same drug.