Medicare Pressed To Expand Home Infusion Emergency Access Plan Even Further
Plan to allow broader coverage for home infused drugs during the COVID-19 emergency prompts opposition from providers seeking an approach more in line with commercial insurance practices.
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Manufacturers seek additional flexibility from Medicare to facilitate home infusions as surveys indicate patient visits to physician offices have dropped by 40% to 68% in recent weeks, signaling a decline in adherence for physician-administered drugs.
Temporary policy may open door to longer term change as Medicare allows reimbursement of at-home administration of non-hospital drugs covered by Part B under a recently-released regulation aiding at encouraging telehealth during the coronavirus outbreak.
Letter from department’s general counsel responds to request from the company for a pre-enforcement advisory opinion. Despite the letter, Lilly maintains its ‘limited distribution program is fully consistent with applicable laws and regulations.’