Fix the Medicare Loop Hole that prevents patients from receiving IV infusions at home.

My name is Bettemarie, and my life depends on life sustaining IV infusions due to a nonfunctioning gut, Mitochondrial disorder, and Dysautonomia.  I fought to gain my independence, went to college, and worked for 14 years as an Occupational Therapist all while connected to an IV that goes directly into a vein in my heart.

My disease progressed and I became unable to work, so I started on Social Security Disability (SSD). Recently I started on Medicare, and was shocked to find out that Medicare does not cover IV infusions in the home, but yet would fully cover them when provided in the hospital, nursing home, or infusion center.

There are many people across the country like me. People who have worked all their life and had good insurance coverage, and now are retired or on SSD, but then discover that the life-saving infusion treatment they need is no longer covered in the home environment under Medicare.

The IV infusions keep me alive! An infusion center would not be an option for me since I am on a few different infusions each day and am connected to an IV around the clock. Plus with my medical condition, frequently I am not well enough to leave the house. At 45, I should not have to move into a nursing home to receive IV infusions. A nursing home costs a lot more than the home environment.

Does it make sense that Medicare would only pay for IV infusions when provided in a medical facility, yet the much cheaper alternative of staying in one’s own home is not even an option?

For 30 years, private insurances have been covering IV infusions in the home because it is cheaper and safer than when provided in a medical facility. Medicare has not caught on to this yet; it does not cover infusions of saline, antibiotics, chemotherapy, IVIG, or medications.

As a result, some people go without treatment, and some try to pay out of pocket so they can stay at home.  The majority of people remain hospitalized longer, are admitted to a nursing home for the duration of treatment, or go to an infusion center each day in order to get the prescribed IV infusion therapy. Lives are turned upside down because Medicare does not cover IV infusions in the home.

You have the power to encourage our legislatures to pass a bill that will save Medicare millions! An independent study shows that Medicare would save $80 million over 10 years if Medicare covered IV antibiotics in the home setting, instead of requiring people to be in a medical setting. The study took into account the increased cost for the infusions, such as nursing and pharmacy services, plus tubing and supplies, and yet there is still a considerable cost savings.

Under Medicare Part D the IV medication is covered, however there is no Medicare part B coverage for the pharmacist to prepare it for use, no coverage for the nursing services, and no coverage for the tubing and supplies.
Legislation to correct the loophole has been introduced into both the House and Senate and is called the Medicare Home Infusion Site of Care Act of 2015 (S. 275 / H.R. 605). This common sense bill corrects the gap in Medicare, and ensures coverage of IV infusions in the home environment. This bill will create a seamless pathway coordinating coverage between Part B and Part D, allowing appropriate and timely access to IV infusions in the home!!!

Infusions can be done safely in the home environment, where it is most cost effective. Please sign my petition asking Congressmen and Senators to support the Medicare Home Infusion Site of Care Act of 2015 (S. 275 / H.R. 605) so patients can receive IV infusions in their own home.