Calls on Congress to Fix Unintended Consequence of 21st Century Cures Act; Encourages Patients, Families, Others to Join Outreach
BANNOCKBURN, Ill., Jan. 23, 2017 — Option Care is working diligently to persuade the U.S. Congress to fix a new law that has caused vulnerable Medicare patients to lose access to home infusion care, and is encouraging those affected to join in advocacy efforts. While promising to help millions of patients via a variety of wide-ranging measures, the new 21st Century Cures Act contains provisions that unintentionally impact patients who need home infusion therapy for advanced heart failure and other conditions.
Option Care is a founding member of Keep My Infusion Care at Home, a coalition of concerned patients, family members, caregivers, healthcare providers and related organizations. The coalition is reaching out to legislators to advocate for a change to the law in order to ensure that Medicare patients have access to high quality home infusion care to support their health and sustain their quality of life.
“Undoubtedly the Cures Act will do great good, but unfortunately some of its smaller provisions have unintended negative consequences, causing disruptions to care as patients transition from hospital to home. That means many Medicare patients no longer have access to home infusion, which provides a safe, effective and typically less costly alternative to inpatient care,” said Paul Mastrapa, CEO, Option Care. “This consequence is particularly poignant for advanced heart failure patients who prefer to receive care at home, but may lose the home infusion care they rely on to sustain their quality of life.”
Many patients with complex health conditions rely on home infusion therapy, which is medication administered through a needle or catheter, and provided in the comfort of their own homes. Heart failure patients who rely on home infusion care to sustain their quality of life may lose that access, forcing them to find alternative treatment options. Hospital systems will suffer as well, as they care for these high-need patients in more costly sites of care than home infusion.
Effective Jan.1, 2017, the Cures Act includes a provision that changed the payment structure for certain infusion drugs under the Part B Durable Medical Equipment (DME) benefit. That created a dramatic reduction in reimbursement that effectively covers only the drug costs and provides no compensation for clinical services to administer the infusion therapy in the home. While a separate provision in the law does provide for clinical services payment, it does not begin until 2021.
Keep My Infusion Care at Home is urging legislators to close this four-year gap in care by aligning the implementation dates for the drug reimbursement change with the new clinical services payment.
In addition to Option Care, Keep My Infusion Care at Home sponsors include the National Home Infusion Association (NHIA) and other leading industry providers. For more information, visit KeepMyInfusionCareAtHome.org. Patients and families are encouraged to join the effort by sharing their stories showing how this law affects real patients, and writing their congressmen to encourage them to amend the law. Organizations interested in joining the coalition should email email@example.com.
About Option Care
Option Care Enterprises, Inc. (Option Care) is one of the nation’s largest and most trusted providers of home and alternate treatment site infusion services. An industry leader, the company draws on nearly 40 years of clinical care experience to offer patient-centered therapy management. Option Care’s signature Home Infusion Plus services include the clinical management of infusion medicines, nursing support and care coordination. Option Care’s multidisciplinary team of more than 1,800 clinicians — including pharmacists, nurses and dietitians — are able to provide home infusion service coverage for nearly all patients across the United States needing treatment for complex and chronic conditions. Learn more at www.OptionCare.com.
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