Update on Home Infusion & Medicare During COVID-19 Pandemic

Earlier this week, the Center for Medicare and Medicaid Services (CMS) released new guidelines for the coverage of home infusion during the COVID-19 pandemic. The new guidelines allow for more flexibility for patients and their physicians to decide the best setting for ongoing treatments. Given your current situation, you may be able to access home infusion through Medicare coverage, but please talk with your healthcare provider as soon as possible to check your eligibility and make the necessary arrangements.

This is a constantly changing situation that will likely continue to evolve while CMS, Congress, and healthcare providers work out the kinks. The GBS|CIDP Foundation International is committed to continuing our advocacy efforts to ensure that all Medicare Part B patients are able to access home infusion through their current coverage. We will continue to advocate for complete coverage of home infusion IVIG throughout the current pandemic, and will eventually advocate for a more permanent benefit.

In the meantime, here are two options for you to discuss with your doctor to possibly access home infusion coverage:

  1. Qualifying for coverage by being “homebound” – Medicare has relaxed its definition of “homebound” to include additional patients that need to stay in their homes due to an elevated health risk posed by COVID-19. Your doctor will help make that determination, and then you may qualify for the Medicare Home Health services.
  2. Relaxed requirements for physician supervision – Medicare has also relaxed the requirement for physician supervision that is usually required for coverage. This is intended to provide hospitals, outpatient clinics, doctor’s office, and related sites of care with the opportunity to extend the services they regularly provide to the home setting. Talk to your provider about setting up home infusion through the Part B Home Infusion therapy services benefit.

Subcutaneous IG remains an option, too, and Medicare is providing more flexibility on coverage for durable medical equipment and telehealth options. Please be sure to talk with your physician about the safest way for you to get your therapy on a regular basis throughout this public health emergency.

After three legislative packages, we continue to work with Congress and CMS to improve access to therapies for patients. There is currently an effort being led by at least 10 Senators to expand Medicare Part B coverage even more to ensure patients are covered, safe, and receiving treatment. Please check back regularly for updates, and be sure to talk to your doctor about your options!

Resources for you and your doctor:

Summary from CMS: https://www.cms.gov/files/document/covid-home-health-agencies.pdf

Foundation Resources: https://www.gbs-cidp.org/covid19/

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