HR-4993 : Still Just a Bill

The "Joe Fiandra Access to Home Infusion Act of 2025" (H.R. 4993) proposes changes to Medicare coverage regarding external infusion pumps and associated home infusion drugs. Here's a summary:

• Expands Medicare Coverage: The bill aims to broaden Medicare coverage to include external infusion pumps and non-self-administrable home infusion drugs, even if they don't meet the standard definition of durable medical equipment for home use.
• Conditions for Coverage: To qualify for this expanded coverage, the following conditions must be met:
  • The Food and Drug Administration (FDA)-approved prescribing information for the drug must specify administration by or under the supervision of a healthcare professional.
  • A qualified home infusion therapy supplier must administer or supervise the drug's administration safely and effectively in the patient's home.
  • The prescribing information must indicate that the drug needs to be infused at least 12 times per year intravenously or subcutaneously, or at infusion rates requiring an external pump.
• Cost Sharing Notification: The Secretary of Health and Human Services is required to notify patients about the cost-sharing implications of choosing home infusion therapy compared to other care settings for infusion drugs under Medicare.
• Effective Date: The changes would take effect one year after the bill's enactment.