S.1058 - Preserving Patient Access to Home Infusion Act (119th Congress)
Summary
S.1058, the Preserving Patient Access to Home Infusion Act, aims to amend Title XVIII of the Social Security Act to improve Medicare coverage for home infusion therapy. The bill focuses on clarifying congressional intent and ensuring continued patient access to these services. It addresses issues related to pharmacy services, payment structures, and the types of healthcare providers authorized to establish and review home infusion plans of care.
Specifically, the bill expands the definition of home infusion therapy to include pharmacy services and allows nurse practitioners and physician assistants to establish and review home infusion plans. It also modifies payment rules to account for scenarios where a qualified home infusion therapy supplier is not physically present in the individual's home.
Furthermore, the bill addresses access to home infusion for non-pump drugs and biologicals, clarifying billing procedures for these substances and modifying payment structures for home infusion supplies.
Expected Effects
The passage of this bill would likely result in increased access to home infusion therapy for Medicare beneficiaries. It will broaden the scope of covered services and allow for more flexible care delivery models. The changes in payment structures could affect the financial viability of home infusion therapy suppliers.
By including pharmacy services and allowing nurse practitioners and physician assistants to oversee care plans, the bill aims to streamline the process and reduce administrative burdens. This could lead to more efficient and patient-centered care.
The modifications to payment rules, especially concerning non-pump drugs and situations where suppliers are not physically present, are intended to ensure fair compensation for services rendered while controlling costs.
Potential Benefits
- Increased access to home infusion therapy for Medicare beneficiaries.
- Broader scope of covered services, including pharmacy services.
- Greater flexibility in care delivery with nurse practitioners and physician assistants involved in care plans.
- Streamlined administrative processes for home infusion therapy suppliers.
- Improved clarity in billing procedures for non-pump drugs and biologicals.
Potential Disadvantages
- Potential for increased costs to the Medicare program due to expanded coverage.
- Possible financial strain on home infusion therapy suppliers due to modified payment structures.
- Risk of inconsistent care quality if nurse practitioners and physician assistants do not adhere to established standards.
- Complexity in implementing the new billing procedures for non-pump drugs.
- Potential for confusion among patients and providers regarding the new rules and regulations.
Constitutional Alignment
The bill aligns with the general welfare clause of the US Constitution, as it aims to improve healthcare access for Medicare beneficiaries. Specifically, it falls under Congress's power to legislate on matters related to healthcare and social security, as outlined in Article I, Section 8.
The bill does not appear to infringe on any specific individual liberties or rights protected by the Bill of Rights. It primarily focuses on modifying existing regulations within the Social Security Act to improve the delivery of home infusion therapy.
However, the constitutionality of specific payment structures and regulatory details could be subject to judicial review if they are challenged as arbitrary or discriminatory.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).