[Congressional Record (Bound Edition), Volume 152 (2006), Part 11]
[Extensions of Remarks]
[Page 14884]
[From the U.S. Government Publishing Office, www.gpo.gov]




IN SUPPORT OF THE MEDICARE HOME INFUSION THERAPY CONSOLIDATED COVERAGE 
                                  ACT

                                 ______
                                 

                            HON. KAY GRANGER

                                of texas

                    in the house of representatives

                         Tuesday, July 18, 2006

  Ms. GRANGER. Mr. Speaker, last week, I introduced H.R. 5791, the 
``Medicare Home Infusion Therapy Consolidated Coverage Act of 2006,'' 
along with my colleagues, Representatives Engel, Kuhl and Baldwin. This 
legislation will bring life-saving, cost-effective treatment to 
Medicare beneficiaries suffering from cancer, serious infections and 
other conditions that can and should be treated by home infusion 
therapy. It does so by first consolidating Medicare coverage of home 
infusion therapy under Part B and then by covering it in a rational and 
logical manner.
  Infusion therapy involves administering medications directly into a 
patient's bloodstream via a catheter or needle. Infusion therapy is 
medically necessary for patients with medical conditions that cannot be 
treated effectively with oral medications. These include infections 
that are unresponsive to oral antibiotics, cancer and cancer-related 
pain, multiple sclerosis, rheumatoid arthritis and more. The infusion 
therapies needed to treat these diseases involve more than the simple 
delivery of drugs. Rather, patients receiving home infusion therapy 
require an array of professional services.
  In addition, infusion patients also require specialized equipment and 
supplies. Even with all of these services and supplies, home infusion 
therapy is often far more cost-effective than obtaining treatment in a 
hospital or nursing home. Unfortunately, there are gaps in coverage 
under Medicare. Consequently, the Medicare program and its 
beneficiaries are not able to take full advantage of the cost savings 
and innovations made possible through home infusion therapy.
  Current Part B coverage of home infusion therapy is limited to what 
is covered under the durable medical equipment benefit, where coverage 
is based on the use of an item of DME (i.e., an infusion pump) for 
administration and extends only to a few drugs. More infusion drugs are 
coverable under the Part D outpatient prescription drug benefit, but 
CMS has determined that it does not have the authority to cover the 
related services, supplies and equipment under Part D. As a result, 
most beneficiaries who cannot afford to pay these costs out-of-pocket 
are forced back into hospitals and nursing homes for their infusion 
treatments. This is a great inconvenience to patients and creates an 
added cost to the taxpayers--a cost that could be avoided.
  Properly provided, home infusion therapy is a clinically and cost-
effective medical treatment for serious diseases. Medicare 
beneficiaries should not continue to be denied access to these 
therapies because of definitional and coverage policies that do not 
reflect the components or the costs of care. Congress can fix this by 
consolidating coverage for home infusion therapy under Part B, apart 
from the DME benefit. In doing so, we can ensure that our constituents 
gain access to these therapies in the most cost-effective and 
convenient setting--their homes.
  Under commercial health plans, home infusion usually is covered as a 
major medical benefit. We should ensure that Medicare can do the same. 
Part B is able to accommodate and reimburse for the multi-faceted 
components of a major medical benefit. My bill allows us to use this 
existing structure to make home infusion therapy work for Medicare 
beneficiaries.
  Every day that passes without complete Medicare coverage of home 
infusion therapy is a missed opportunity to bring cost-effective care 
in to the most convenient setting to beneficiaries. I urge my 
colleagues to support this critical legislation.

                          ____________________