,i #aaith ,,congress #ast ,session ,h4 ,r4 #bagb ,,in ,,the ,,house ,,of ,,representatives ,march #ah1 #bjbe,mr4 ,buchanan 7for himself1 ,mrs4 ,dingell1 ,mrs4 ,harshbarger1 and ,ms4 ,sewell7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 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 program1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,preserving ,patient ,access to ,home ,infusion ,act4 #b4 ,preservation of patient access to home infusion therapy under ,medicare program 7a7 ,inclusion of pharmacy services ,section #ahfa7;iii77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7iii77#b77 is amended-- 7#a7 in subparagraph 7,a71 by inserting and pharmacy services after nursing services2 and 7#b7 in subparagraph 7,b71 by inserting 1 assessments1 drug preparation and compounding1 coordination and documentation of infusion therapy services in the plan of care after subsection 7n774 7b7 ,payment ,section #ahcd7u77#a77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7u77#a77;,a77 is amended-- 7#a7 in clause 7i71 by striking clause 7iii7 and inserting clauses 7iii7 and 7iv72 7#b7 in clause 7ii7 by inserting after the first sentence the following new sentence3 ,for purposes of the previous sentence1 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 7regardless of whether a qualified home infusion therapy supplier was physically present in the home of such individual on such date742 7#c7 in clause 7iii7-- 7,a7 by striking ,the single payment amount and inserting the following3 7,i7 ,in general ,subject to subclause 7,,ii71 the single payment amount 2 and 7,b7 by adding at the end the following new subclause3 7,,ii7 ,transitional rule ,for home infusion therapy furnished on or after ,january #a1 #bjbf1 and before ,january #a1 #bjcj1 the ,secretary shall ensure that the single payment amount determined under this subparagraph reflects #e hours of infusion for a particular therapy in a calendar day4 2 and 7#d7 by adding at the end the following new clause3 7iv7 ,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 individual1 the single payment amount under this subsection for items and services described in clause 7i7 furnished on such day to such individual shall be an amount equal to #ej percent of the amount that would have applied under this subsection for such items and services if such a supplier had been physically present4 4 7c7 ,permitting nurse practitioners and physician assistants ,to establish and review a home infusion plan of care ,section #ahfa7;iii77#a77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7iii77#a77;,b77 is amended by striking physician 7as defined in subsection 7r77#a77 and is periodically reviewed by a physician and inserting physician 7as defined in subsection 7r77#a77 or a nurse practitioner or physician assistant 7as those terms are defined in subsection 7aa77#e77 and is periodically reviewed by a physician1 nurse practitioner1 or physician assistant4 7d7 ,effective date ,the amendments made by this section shall apply with respect to items and services furnished on or after ,january #a1 #bjbf4 #c4 ,access to home infusion for non-pump drugs and biologicals 7a7 ,modification of definition of home infusion drug ,section #ahfa7;iii77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7iii77#c77 is amended-- 7#a7 in subparagraph 7,c71 by inserting and1 in the case of a drug or biological other than a specified non-pump drug or biological 7as defined in subparagraph 7,e771 before through2 and 7#b7 by adding at the end the following new subparagraph3 7,e7 ,the term specified non-pump drug or biological means a drug or biological that-- 7i7 is administered intravenously but not through a pump that is an item of durable medical equipment 7as defined in subsection 7n772 and 7ii7 is an antibacterial1 antifungal1 or antiviral 7as categorized by the ,united ,states ,pharmacopeia74 4 7b7 ,clarification on billing ,section #ahcd7u7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7u77 is amended by adding at the end the following new paragraph3 7#h7 ,clarification on billing for a specified non-pump drug or biological ,in the case of a qualified home infusion supplier 7as defined in section #ahfa7;iii77#c77;,d77 that furnishes items and services described in subparagraphs 7,a7 and 7,b7 of section #ahfa7;iii77#b7 in coordination with the furnishing of a home infusion drug 7as defined in section #ahfa7;iii77#c77;,c77 that is a specified non-pump drug or biological 7as defined in section #ahfa7;iii77#c77;,e77 where the method of infusion utilized in furnishing such drug or biological does not involve a pump that is an item of durable medical equipment1 payment under this subsection for the items and services described in subparagraphs 7,a7 and 7,b7 of section #ahfa7;iii77#b7 shall be made with respect to such drug or biological regardless of whether such drug or biological so furnished is payable under this part4 4 7c7 ,effective date ,the amendments made by this section shall apply with respect to items and services furnished on or after ,january #a1 #bjbf4 #d4 ,modification of payment for home infusion supplies ,section #ahcd7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7a77 is amended by adding at the end the following new paragraph3 7#bb7 ,special payment rule for items and supplies furnished in conjunction with home infusion therapy 7,a7 ,in general ,notwithstanding the preceding provisions of this subsection1 no payment may be made under this subsection with respect to applicable items and services 7as defined in subparagraph 7,b77 that are furnished on or after ,january #a1 #bjbf1 in conjunction home infusion therapy 7as defined in section #ahfa7;iii77#a77 for which payment is made under subsection 7u7 and which are so furnished on the same day as such home infusion therapy and with respect to the same home infusion drug 7as defined in section #ahfa7;iii77#c77;,c77 for which such payment was so made4 7,b7 ,applicable items and services defined ,for purposes of subparagraph 7,a71 the term applicable items and services means tubing1 catheters1 dressings1 needles1 syringes1 and other supplies identified by ,,hcpcs code ,a#dbba1 ,a#dbbb1 or ,k#jeeb 7or any successor code74 4