Us Congress 2025-2026 Regular Session

Us Congress House Bill HB2172 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	I
2	2	119THCONGRESS
3	3	1
4	4	STSESSION H. R. 2172
5	5	To amend title XVIII of the Social Security Act to clarify congressional
6	6	intent and preserve patient access to home infusion therapy under the
7	7	Medicare program, and for other purposes.
8	8	IN THE HOUSE OF REPRESENTATIVES
9	9	MARCH18, 2025
10	10	Mr. B
11	11	UCHANAN(for himself, Mrs. DINGELL, Mrs. HARSHBARGER, and Ms.
12	12	S
13	13	EWELL) introduced the following bill; which was referred to the Com-
14	14	mittee on Energy and Commerce, and in addition to the Committee on
15	15	Ways and Means, for a period to be subsequently determined by the
16	16	Speaker, in each case for consideration of such provisions as fall within
17	17	the jurisdiction of the committee concerned
18	18	A BILL
19	19	To amend title XVIII of the Social Security Act to clarify
20	20	congressional intent and preserve patient access to home
21	21	infusion therapy under the Medicare program, and for
22	22	other purposes.
23	23	Be it enacted by the Senate and House of Representa-1
24	24	tives of the United States of America in Congress assembled, 2
25	25	SECTION 1. SHORT TITLE. 3
26	26	This Act may be cited as the ‘‘Preserving Patient Ac-4
27	27	cess to Home Infusion Act’’. 5
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30	30	•HR 2172 IH
31	31	SEC. 2. PRESERVATION OF PATIENT ACCESS TO HOME IN-1
32	32	FUSION THERAPY UNDER MEDICARE PRO-2
33	33	GRAM. 3
34	34	(a) I
35	35	NCLUSION OFPHARMACYSERVICES.—Section 4
36	36	1861(iii)(2) of the Social Security Act (42 U.S.C. 5
37	37	1395x(iii)(2)) is amended— 6
38	38	(1) in subparagraph (A), by inserting ‘‘and 7
39	39	pharmacy services’’ after ‘‘nursing services’’; and 8
40	40	(2) in subparagraph (B), by inserting ‘‘, assess-9
41	41	ments, drug preparation and compounding, coordi-10
42	42	nation and documentation of infusion therapy serv-11
43	43	ices in the plan of care’’ after ‘‘subsection (n))’’. 12
44	44	(b) P
45	45	AYMENT.—Section 1834(u)(1)(A) of the Social 13
46	46	Security Act (42 U.S.C. 1395m(u)(1)(A)) is amended— 14
47	47	(1) in clause (i), by striking ‘‘clause (iii)’’ and 15
48	48	inserting ‘‘clauses (iii) and (iv)’’; 16
49	49	(2) in clause (ii) by inserting after the first sen-17
50	50	tence the following new sentence: ‘‘For purposes of 18
51	51	the previous sentence, a reference to payment to a 19
52	52	qualified home infusion therapy supplier for an infu-20
53	53	sion drug administration calendar day in the home 21
54	54	of such individual shall refer to payment for each 22
55	55	day on which such a drug was administered to the 23
56	56	individual (regardless of whether a qualified home 24
57	57	infusion therapy supplier was physically present in 25
58	58	the home of such individual on such date).’’; 26
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61	61	•HR 2172 IH
62	62	(3) in clause (iii)— 1
63	63	(A) by striking ‘‘The single payment 2
64	64	amount’’ and inserting the following: 3
65	65	‘‘(I) I
66	66	N GENERAL.—Subject to 4
67	67	subclause (II), the single payment 5
68	68	amount’’; and 6
69	69	(B) by adding at the end the following new 7
70	70	subclause: 8
71	71	‘‘(II) T
72	72	RANSITIONAL RULE.—For 9
73	73	home infusion therapy furnished on or 10
74	74	after January 1, 2026, and before 11
75	75	January 1, 2030, the Secretary shall 12
76	76	ensure that the single payment 13
77	77	amount determined under this sub-14
78	78	paragraph reflects 5 hours of infusion 15
79	79	for a particular therapy in a calendar 16
80	80	day.’’; and 17
81	81	(4) by adding at the end the following new 18
82	82	clause: 19
83	83	‘‘(iv) S
84	84	PECIAL RULE WHEN A QUALI -20
85	85	FIED HOME INFUSION THERAPY SUPPLIER 21
86	86	NOT PHYSICALLY PRESENT IN THE INDI -22
87	87	VIDUAL’S HOME.—In the case where a 23
88	88	qualified home infusion therapy supplier is 24
89	89	not physically present in the individual’s 25
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92	92	•HR 2172 IH
93	93	home on the day the home infusion drug is 1
94	94	administered to the individual, the single 2
95	95	payment amount under this subsection for 3
96	96	items and services described in clause (i) 4
97	97	furnished on such day to such individual 5
98	98	shall be an amount equal to 50 percent of 6
99	99	the amount that would have applied under 7
100	100	this subsection for such items and services 8
101	101	if such a supplier had been physically 9
102	102	present.’’. 10
103	103	(c) P
104	104	ERMITTINGNURSEPRACTITIONERS ANDPHYSI-11
105	105	CIANASSISTANTSTOESTABLISH ANDREVIEW AHOME 12
106	106	I
107	107	NFUSIONPLAN OFCARE.—Section 1861(iii)(1)(B) of the 13
108	108	Social Security Act (42 U.S.C. 1395x(iii)(1)(B)) is 14
109	109	amended by striking ‘‘physician (as defined in subsection 15
110	110	(r)(1)) and is periodically reviewed by a physician’’ and 16
111	111	inserting ‘‘physician (as defined in subsection (r)(1)) or 17
112	112	a nurse practitioner or physician assistant (as those terms 18
113	113	are defined in subsection (aa)(5)) and is periodically re-19
114	114	viewed by a physician, nurse practitioner, or physician as-20
115	115	sistant’’. 21
116	116	(d) E
117	117	FFECTIVEDATE.—The amendments made by 22
118	118	this section shall apply with respect to items and services 23
119	119	furnished on or after January 1, 2026. 24
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123	123	SEC. 3. ACCESS TO HOME INFUSION FOR NON-PUMP DRUGS 1
124	124	AND BIOLOGICALS. 2
125	125	(a) M
126	126	ODIFICATION OFDEFINITION OFHOMEINFU-3
127	127	SIONDRUG.—Section 1861(iii)(3) of the Social Security 4
128	128	Act (42 U.S.C. 1395x(iii)(3)) is amended— 5
129	129	(1) in subparagraph (C), by inserting ‘‘and, in 6
130	130	the case of a drug or biological other than a speci-7
131	131	fied non-pump drug or biological (as defined in sub-8
132	132	paragraph (E)),’’ before ‘‘through’’; and 9
133	133	(2) by adding at the end the following new sub-10
134	134	paragraph: 11
135	135	‘‘(E) The term ‘specified non-pump drug or bio-12
136	136	logical’ means a drug or biological that— 13
137	137	‘‘(i) is administered intravenously but not 14
138	138	through a pump that is an item of durable med-15
139	139	ical equipment (as defined in subsection (n)); 16
140	140	and 17
141	141	‘‘(ii) is an antibacterial, antifungal, or 18
142	142	antiviral (as categorized by the United States 19
143	143	Pharmacopeia).’’. 20
144	144	(b) C
145	145	LARIFICATION ONBILLING.—Section 1834(u) 21
146	146	of the Social Security Act (42 U.S.C. 1395m(u)) is 22
147	147	amended by adding at the end the following new para-23
148	148	graph: 24
149	149	‘‘(8) C
150	150	LARIFICATION ON BILLING FOR A SPECI -25
151	151	FIED NON-PUMP DRUG OR BIOLOGICAL .—In the case 26
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154	154	•HR 2172 IH
155	155	of a qualified home infusion supplier (as defined in 1
156	156	section 1861(iii)(3)(D)) that furnishes items and 2
157	157	services described in subparagraphs (A) and (B) of 3
158	158	section 1861(iii)(2) in coordination with the fur-4
159	159	nishing of a home infusion drug (as defined in sec-5
160	160	tion 1861(iii)(3)(C)) that is a specified non-pump 6
161	161	drug or biological (as defined in section 7
162	162	1861(iii)(3)(E)) where the method of infusion uti-8
163	163	lized in furnishing such drug or biological does not 9
164	164	involve a pump that is an item of durable medical 10
165	165	equipment, payment under this subsection for the 11
166	166	items and services described in subparagraphs (A) 12
167	167	and (B) of section 1861(iii)(2) shall be made with 13
168	168	respect to such drug or biological regardless of 14
169	169	whether such drug or biological so furnished is pay-15
170	170	able under this part.’’. 16
171	171	(c) E
172	172	FFECTIVEDATE.—The amendments made by 17
173	173	this section shall apply with respect to items and services 18
174	174	furnished on or after January 1, 2026. 19
175	175	SEC. 4. MODIFICATION OF PAYMENT FOR HOME INFUSION 20
176	176	SUPPLIES. 21
177	177	Section 1834(a) of the Social Security Act (42 U.S.C. 22
178	178	1395m(a)) is amended by adding at the end the following 23
179	179	new paragraph: 24
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183	183	‘‘(22) SPECIAL PAYMENT RULE FOR ITEMS AND 1
184	184	SUPPLIES FURNISHED IN CONJUNCTION WITH HOME 2
185	185	INFUSION THERAPY.— 3
186	186	‘‘(A) I
187	187	N GENERAL.—Notwithstanding the 4
188	188	preceding provisions of this subsection, no pay-5
189	189	ment may be made under this subsection with 6
190	190	respect to applicable items and services (as de-7
191	191	fined in subparagraph (B)) that are furnished 8
192	192	on or after January 1, 2026, in conjunction 9
193	193	home infusion therapy (as defined in section 10
194	194	1861(iii)(1)) for which payment is made under 11
195	195	subsection (u) and which are so furnished on 12
196	196	the same day as such home infusion therapy 13
197	197	and with respect to the same home infusion 14
198	198	drug (as defined in section 1861(iii)(3)(C)) for 15
199	199	which such payment was so made. 16
200	200	‘‘(B) A
201	201	PPLICABLE ITEMS AND SERVICES 17
202	202	DEFINED.—For purposes of subparagraph (A), 18
203	203	the term ‘applicable items and services’ means 19
204	204	tubing, catheters, dressings, needles, syringes, 20
205	205	and other supplies identified by HCPCS code 21
206	206	A4221, A4222, or K0552 (or any successor 22
207	207	code).’’. 23
208	208	Æ
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