I
119THCONGRESS
1
STSESSION H. R. 2172
To amend title XVIII of the Social Security Act to clarify congressional
intent and preserve patient access to home infusion therapy under the
Medicare program, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
MARCH18, 2025
Mr. B
UCHANAN(for himself, Mrs. DINGELL, Mrs. HARSHBARGER, and Ms.
S
EWELL) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall within
the jurisdiction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to clarify
congressional intent and preserve patient access to home
infusion therapy under the Medicare program, and for
other purposes.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Preserving Patient Ac-4
cess to Home Infusion Act’’. 5
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SEC. 2. PRESERVATION OF PATIENT ACCESS TO HOME IN-1
FUSION THERAPY UNDER MEDICARE PRO-2
GRAM. 3
(a) I
NCLUSION OFPHARMACYSERVICES.—Section 4
1861(iii)(2) of the Social Security Act (42 U.S.C. 5
1395x(iii)(2)) is amended— 6
(1) in subparagraph (A), by inserting ‘‘and 7
pharmacy services’’ after ‘‘nursing services’’; and 8
(2) in subparagraph (B), by inserting ‘‘, assess-9
ments, drug preparation and compounding, coordi-10
nation and documentation of infusion therapy serv-11
ices in the plan of care’’ after ‘‘subsection (n))’’. 12
(b) P
AYMENT.—Section 1834(u)(1)(A) of the Social 13
Security Act (42 U.S.C. 1395m(u)(1)(A)) is amended— 14
(1) in clause (i), by striking ‘‘clause (iii)’’ and 15
inserting ‘‘clauses (iii) and (iv)’’; 16
(2) in clause (ii) by inserting after the first sen-17
tence the following new sentence: ‘‘For purposes of 18
the previous sentence, a reference to payment to a 19
qualified home infusion therapy supplier for an infu-20
sion drug administration calendar day in the home 21
of such individual shall refer to payment for each 22
day on which such a drug was administered to the 23
individual (regardless of whether a qualified home 24
infusion therapy supplier was physically present in 25
the home of such individual on such date).’’; 26
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(3) in clause (iii)— 1
(A) by striking ‘‘The single payment 2
amount’’ and inserting the following: 3
‘‘(I) I
N GENERAL.—Subject to 4
subclause (II), the single payment 5
amount’’; and 6
(B) by adding at the end the following new 7
subclause: 8
‘‘(II) T
RANSITIONAL RULE.—For 9
home infusion therapy furnished on or 10
after January 1, 2026, and before 11
January 1, 2030, the Secretary shall 12
ensure that the single payment 13
amount determined under this sub-14
paragraph reflects 5 hours of infusion 15
for a particular therapy in a calendar 16
day.’’; and 17
(4) by adding at the end the following new 18
clause: 19
‘‘(iv) S
PECIAL RULE WHEN A QUALI -20
FIED HOME INFUSION THERAPY SUPPLIER 21
NOT PHYSICALLY PRESENT IN THE INDI -22
VIDUAL’S HOME.—In the case where a 23
qualified home infusion therapy supplier is 24
not physically present in the individual’s 25
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home on the day the home infusion drug is 1
administered to the individual, the single 2
payment amount under this subsection for 3
items and services described in clause (i) 4
furnished on such day to such individual 5
shall be an amount equal to 50 percent of 6
the amount that would have applied under 7
this subsection for such items and services 8
if such a supplier had been physically 9
present.’’. 10
(c) P
ERMITTINGNURSEPRACTITIONERS ANDPHYSI-11
CIANASSISTANTSTOESTABLISH ANDREVIEW AHOME 12
I
NFUSIONPLAN OFCARE.—Section 1861(iii)(1)(B) of the 13
Social Security Act (42 U.S.C. 1395x(iii)(1)(B)) is 14
amended by striking ‘‘physician (as defined in subsection 15
(r)(1)) and is periodically reviewed by a physician’’ and 16
inserting ‘‘physician (as defined in subsection (r)(1)) or 17
a nurse practitioner or physician assistant (as those terms 18
are defined in subsection (aa)(5)) and is periodically re-19
viewed by a physician, nurse practitioner, or physician as-20
sistant’’. 21
(d) E
FFECTIVEDATE.—The amendments made by 22
this section shall apply with respect to items and services 23
furnished on or after January 1, 2026. 24
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SEC. 3. ACCESS TO HOME INFUSION FOR NON-PUMP DRUGS 1
AND BIOLOGICALS. 2
(a) M
ODIFICATION OFDEFINITION OFHOMEINFU-3
SIONDRUG.—Section 1861(iii)(3) of the Social Security 4
Act (42 U.S.C. 1395x(iii)(3)) is amended— 5
(1) in subparagraph (C), by inserting ‘‘and, in 6
the case of a drug or biological other than a speci-7
fied non-pump drug or biological (as defined in sub-8
paragraph (E)),’’ before ‘‘through’’; and 9
(2) by adding at the end the following new sub-10
paragraph: 11
‘‘(E) The term ‘specified non-pump drug or bio-12
logical’ means a drug or biological that— 13
‘‘(i) is administered intravenously but not 14
through a pump that is an item of durable med-15
ical equipment (as defined in subsection (n)); 16
and 17
‘‘(ii) is an antibacterial, antifungal, or 18
antiviral (as categorized by the United States 19
Pharmacopeia).’’. 20
(b) C
LARIFICATION ONBILLING.—Section 1834(u) 21
of the Social Security Act (42 U.S.C. 1395m(u)) is 22
amended by adding at the end the following new para-23
graph: 24
‘‘(8) C
LARIFICATION ON BILLING FOR A SPECI -25
FIED NON-PUMP DRUG OR BIOLOGICAL .—In the case 26
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of a qualified home infusion supplier (as defined in 1
section 1861(iii)(3)(D)) that furnishes items and 2
services described in subparagraphs (A) and (B) of 3
section 1861(iii)(2) in coordination with the fur-4
nishing of a home infusion drug (as defined in sec-5
tion 1861(iii)(3)(C)) that is a specified non-pump 6
drug or biological (as defined in section 7
1861(iii)(3)(E)) where the method of infusion uti-8
lized in furnishing such drug or biological does not 9
involve a pump that is an item of durable medical 10
equipment, payment under this subsection for the 11
items and services described in subparagraphs (A) 12
and (B) of section 1861(iii)(2) shall be made with 13
respect to such drug or biological regardless of 14
whether such drug or biological so furnished is pay-15
able under this part.’’. 16
(c) E
FFECTIVEDATE.—The amendments made by 17
this section shall apply with respect to items and services 18
furnished on or after January 1, 2026. 19
SEC. 4. MODIFICATION OF PAYMENT FOR HOME INFUSION 20
SUPPLIES. 21
Section 1834(a) of the Social Security Act (42 U.S.C. 22
1395m(a)) is amended by adding at the end the following 23
new paragraph: 24
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‘‘(22) SPECIAL PAYMENT RULE FOR ITEMS AND 1
SUPPLIES FURNISHED IN CONJUNCTION WITH HOME 2
INFUSION THERAPY.— 3
‘‘(A) I
N GENERAL.—Notwithstanding the 4
preceding provisions of this subsection, no pay-5
ment may be made under this subsection with 6
respect to applicable items and services (as de-7
fined in subparagraph (B)) that are furnished 8
on or after January 1, 2026, in conjunction 9
home infusion therapy (as defined in section 10
1861(iii)(1)) for which payment is made under 11
subsection (u) and which are so furnished on 12
the same day as such home infusion therapy 13
and with respect to the same home infusion 14
drug (as defined in section 1861(iii)(3)(C)) for 15
which such payment was so made. 16
‘‘(B) A
PPLICABLE ITEMS AND SERVICES 17
DEFINED.—For purposes of subparagraph (A), 18
the term ‘applicable items and services’ means 19
tubing, catheters, dressings, needles, syringes, 20
and other supplies identified by HCPCS code 21
A4221, A4222, or K0552 (or any successor 22
code).’’. 23
Æ
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