Vizient and Provista insist CMS to reassess approach to Medicare home infusion therapy benefits

Vizient, the largest member-driven health care performance improvement company in the country and its subsidiary Provista, a leading supply chain partner for non-acute health care delivery organizations, urge CMS to reconsider its approach to the Medicare home infusion therapy benefit to recognize the full array of services needed for home infusion therapy services.

Yesterday afternoon CMS finalized a very narrow interpretation of the new Medicare home infusion benefit in the Home Health Prospective Payment System final rule for 2019. The final rule will limit reimbursement for home infusion services to only "the day on which home infusion therapy services are furnished by skilled professionals in the individual's home." Under this approach, Medicare fails to adequately reimburse for professional services, such as pharmacy and patient management services, needed for home infusion therapy. Unfortunately, this decision will likely limit patient access to high-quality, low-cost, home infusion services.

While Vizient and Provista appreciate that CMS will continue monitoring the situation and accepting additional feedback, it is clear that the approach adopted in the final Home Health payment rule is not sufficient and changes are needed to support beneficiary access to home infusion therapy services.