With a quarter of the world’s population under some form of lockdown, public health officials are stressing the importance of staying home and avoiding unnecessary trips to a hospital for minor ailments.
But, staying at home isn’t an option for some patients most at-risk from serious complications from coronavirus. That’s because Medicare rules block patients with underlying health conditions, including cancer, osteoporosis, and asthma, from accessing their treatments at home.
“It’s never been more dangerous for patients with compromised immune systems to visit a hospital,” explains Terry Wilcox, executive director of Patients Rising, a national patient advocacy non-profit organization that helps patients overcome access barriers. “In-home care can save lives, yet Medicare rules block patients with compromised immune systems from getting their treatments at home.”
Under Medicare Part B, millions of patients with underlying health conditions are required to receive injection or infusion treatments administered by a health care provider at a clinic or hospital outpatient department.
“Every time a patient visits a clinic for an injected or infused treatment, she is risking her health,” warns Wilcox of Patients Rising.
In-Home Care Providers Ready to Fill the Gap
By requiring patients to receive injections in a clinical setting, it is placing an unnecessary burden on our medical system during this national emergency. Many of these facilities are currently overburdened or are preparing to accommodate patients as a result of the COVID-19 pandemic. Moreover, patients with underlying health conditions are among the most susceptible to severe outcomes from COVID-19.
“Home infusion providers have the ability to serve more Medicare patients who wish to remain at home, but unfortunately Medicare is the only major payer of health care services in the United States to have severe limitations on this benefit,” Connie Sullivan, president and CEO of the National Home Infusion Association, writes at Morning Consult.
Connie Sullivan, President and CEO, NHIA
Sullivan points out that under existing rules patients with Medicare coverage would be forced to pay out-of-pocket for an IV infusion at home.
“Medicare’s policy is counterintuitive under normal circumstances and just plain dangerous as we expect an influx of patients seeking treatment for infection arriving to these sites of care,” she adds. “If you are a patient at high risk for serious complications, the best way to avoid COVID-19 is to stay at home and limit the chances of exposure to others who might be infected.”
As an alternative to a clinical setting that unnecessarily compromises a patient’s health, many patients say that they would prefer to access care from an in-home care provider.
“Patients are terrified to leave their home for scheduled infusion injections and infusions for fear of contracting COVID-19,” explains Steven Newmark, director of policy and general counsel at the Global Healthy Living Foundation. “For Medicare patients, it is vital that they are able to receive their medications at home during this crisis through appropriate providers and clinical staff with the expertise to administer these drugs safely to prevent the transfer of COVID-19 infection to patients and to the population at large.”
Emergency Legislation: Preserving Patient Access to Home Infusion Act
To correct the problem, a bipartisan coalition has authored emergency legislation that would temporarily give Medicare Part B patients the option to access injected or infused treatments in their home from a home health care provider. In addition to protecting patients, the legislation would alleviate the burdens on our clinics, hospitals and outpatient departments during this public health crisis.
“Medicare’s home infusion therapy benefit provides increased access to care for patients with immune diseases, cancer, serious infections, heart failure and other conditions that might otherwise force these patients to receive their care in a more expensive and less convenient hospital or nursing home setting,” said Senator Mark Warner of Virginia. “This legislation will ensure that Medicare enrollees in need of home infusion therapy can get the care they need in a more comfortable environment and at a more reasonable cost to the federal government.”
Patients and providers say that the emergency legislation is an easy way to protect patients and alleviate the burden on medical facilities during the coronavirus crisis.
“Patients are grateful to this bipartisan coalition for showing leadership during this public health crisis,” said Wilcox of Patients Rising. “We urge Congress to take swift action to pass this common sense legislation.”
The Preserving Patient Access to Home Infusion Act is authored by U.S. Senators Tim Scott of South Carolina and Mark Warner of Virginia; and Representatives Elliot Engel of New York, Terri Sewell of Alabama, Kenny Marchant of Texas, and Fred Upton of Michigan.
