Infectious Disease Doctors Urge Congress To Cover Home Infusion Therapy For Medicare Beneficiaries
Main Category: Infectious Diseases / Bacteria / VirusesAlso Included In: Medicare / Medicaid / SCHIP
Article Date: 10 Jun 2007 - 8:00 PDT
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The Infectious Diseases Society of America (IDSA) is urging Congress to support the Medicare Home Infusion Therapy Coverage Act of 2007 (H.R. 2567), bipartisan legislation introduced by Reps. Eliot Engel (D-NY), Kay Granger (R-TX), Tammy Baldwin (D-WI), Charles Pickering (R-MS), Randy Kuhl (R-NY), and John Tierney (D-MA). The long-awaited bill would extend coverage for home infusion services to Medicare beneficiaries - a benefit enjoyed by most patients in the private sector.
When Congress passed the Medicare Modernization Act in 2003, lawmakers added coverage for home infusion drugs including antibiotics, antivirals, and antifungal drugs, which are prescribed for patients with serious infections, such as bone and skin infections, heart infections, pneumonia, and urinary tract infections.
"Congress correctly understood what many private payers have realized for decades - that a home infusion therapy benefit under Medicare would reduce hospital stays and decrease costs. For my patients, who are already actively fighting infections, quality care in the home is preferred because it reduces their exposure to other infections in the hospital," says IDSA President-Elect Donald M. Poretz, MD, who has provided such therapy to his privately insured patients for years.
Unfortunately, the Centers for Medicare and Medicaid Services (CMS) interpreted the law to cover only the drugs but not the services and supplies associated with home infusion therapy, including pharmacy and care coordination services, medical supplies and equipment, and when necessary nursing services.
"As a result, my Medicare patients must come to my office, stay in the hospital, or live in a nursing home to receive antimicrobial infusion services," Dr. Poretz says.
Not only is this inconvenient or difficult for Medicare patients - particularly those in rural areas and elderly and infirm Medicare patients, including those with Alzheimer's and dementia - but it also may result in higher costs for the Medicare program.
In addition to potential cost savings, home infusion therapy can be safer for patients because they are less likely to be exposed to hospital-acquired, drug-resistant infections. Annually, nearly 2 million U.S. patients acquire infections in the hospital and nearly one in 10 die from them.
H.R. 2567 would give Medicare beneficiaries access to the same life saving drug therapies in the home setting that are already enjoyed by most privately insured patients. It would ensure that the highest quality standards are employed to ensure safety and effectiveness of home infusions. And, it would enable Medicare to realize the efficiencies and positive outcomes that home infusion therapy has brought to the private sector.
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IDSA is an organization of physicians, scientists, and other health care professionals dedicated to promoting health through excellence in infectious diseases research, education, prevention, and patient care. The Society, which has more than 8,000 members, was founded in 1963 and is based in Arlington, VA. For more information, see http://www.idsociety.org/.
Contact: Steve Baragona
Infectious Diseases Society of America
Visit our infectious diseases / bacteria / viruses section for the latest news on this subject.
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Medicare Home Infusion Therapy Coverage Act Of 2007
posted by Miss_Shawnee on 11 Jun 2007 at 7:33 amIn reference to the Medicare Modernization Act of 2003, I often wonder if they (Congress, USA) were thinking with their "right or left" brains. I have been on Medical Disability since 1994 and on Medicaid/Medicare A-B ever since. Up until the "New" Medicare D kicked in, I was doing pretty good on getting what I needed including the needed medications that are so ridiculously expensive. The "New" revamped Medicare has turned my life upside down! Taken away drug therapies that were working and forced to try new ones that are causing more complications, which in turn, cost more to treat for hospital visits, specialists, more drugs, and it's definitely not cost effective for the System.
But they won't listen when you tell them, because they think they are right. I have also needed home infusion therapy and ended up going to a wound care clinic for four weeks every day because the authorization did not come for them to come into my home. I keep getting their little drug formularys each month telling me what they will and will not cover. If they decide not to cover one of my now covered drugs, my doctor has to choose one of their alternatives and see if it works. I think that's a bunch of crap! I am on too many meds now to be messing around with compatibility and insurance that doesn't want to pay the tier 1 price. I've been on the appeal pages too. Doc and I appealed just one of my meds four times and every time it was DENIED! Sad, frustrated, mad, sometimes I feel my quality of life slipping away because money is more important to some than the quality of care provided and guaranteed as a right to every citizen. Parity in Health care and Mental Illness care Period.
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