[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4104 Introduced in House (IH)]

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118th CONGRESS
  1st Session
                                H. R. 4104

      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

                             June 14, 2023

  Mr. Buchanan (for himself, Mrs. Dingell, Mrs. Harshbarger, and Ms. 
   Sewell) introduced the following bill; which was referred to the 
 Committee 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 Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Preserving Patient Access to Home 
Infusion Act''.

SEC. 2. PRESERVATION OF PATIENT ACCESS TO HOME INFUSION THERAPY UNDER 
              MEDICARE PROGRAM.

    (a) Inclusion of Pharmacy Services.--Section 1861(iii)(2) of the 
Social Security Act (42 U.S.C. 1395x(iii)(2)) is amended--
            (1) in subparagraph (A), by inserting ``and pharmacy 
        services'' after ``nursing services''; and
            (2) in subparagraph (B), by inserting ``, assessments, drug 
        preparation and compounding, coordination and documentation of 
        infusion therapy services in the plan of care'' after 
        ``subsection (n))''.
    (b) Payment.--Section 1834(u)(1)(A) of the Social Security Act (42 
U.S.C. 1395m(u)(1)(A)) is amended--
            (1) in clause (i), by striking ``clause (iii)'' and 
        inserting ``clauses (iii) and (iv)'';
            (2) in clause (ii) by inserting after the first sentence 
        the following new sentence: ``For purposes of the previous 
        sentence, a reference to payment to a qualified home infusion 
        therapy supplier for an infusion drug administration calendar 
        day in the home of such individual shall refer to payment for 
        each day on which such a drug was administered to the 
        individual (regardless of whether a qualified home infusion 
        therapy supplier was physically present in the home of such 
        individual on such date).''; and
            (3) by adding at the end the following new clause:
                            ``(iv) Special rule when a qualified home 
                        infusion therapy supplier not physically 
                        present in the individual's home.--In the case 
                        where a qualified home infusion therapy 
                        supplier is not physically present in the 
                        individual's home on the day the home infusion 
                        drug is administered to the individual, the 
                        single payment amount under this subsection for 
                        items and services described in clause (i) 
                        furnished on such day to such individual shall 
                        be an amount equal to 50 percent of the amount 
                        that would have applied under this subsection 
                        for such items and services if such a supplier 
                        had been physically present.''.
    (c) Permitting Nurse Practitioners and Physician Assistants To 
Establish and Review a Home Infusion Plan of Care.--Section 
1861(iii)(1)(B) of the Social Security Act (42 U.S.C. 1395x(iii)(1)(B)) 
is amended by striking ``physician (as defined in subsection (r)(1)) 
and is periodically reviewed by a physician'' and inserting ``physician 
(as defined in subsection (r)(1)) or a nurse practitioner or physician 
assistant (as those terms are defined in subsection (aa)(5)) and is 
periodically reviewed by a physician, nurse practitioner, or physician 
assistant''.
    (d) Effective Date.--The amendments made by this section shall 
apply with respect to items and services furnished on or after January 
1, 2024.
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