NASP Statement on the 21st Century Cures Act (H.R. 34)
December 6, 2016 – The National Association of Specialty Pharmacy (NASP) strongly supports the passage of legislation that aligns with improving patient care, medication access, quality outcomes and the review and approval of lifesaving drugs. While the 21st Century Cures Act (H.R. 34) invests nearly $1.8 billion in new resources to transform cancer research and accelerate discoveries and nearly $3 billion to continue the President’s signature biomedical research initiatives, which creates new research models focused on finding cures, we are specifically concerned with Section 5004 of the Act.
Under the proposed legislation, Section 5004 changes the reimbursement methodology for infusion drugs furnished through an item of DME from one which allows home infusion providers to cover the costs associated with home infusion including the medication cost and the professional nursing services required, to a pricing structure which may cover the medication cost but would no longer cover the costs of the professional services required for home infusion. While Section 5012 of the Cures Act does create a separate fee for the professional services, this does not become effective until January 1, 2021. This creates a four-year gap where home infusion providers will not be reimbursed for professional services.
It is widely recognized that the patient’s home is the most comfortable and cost effective site of service, offering a personalized approach which improves therapy compliance and outcomes. For patients living in remote areas or those relying on caregivers to help with their care, home infusion can be the difference in a patient being able to schedule, afford, and receive the treatment they require. NASP is concerned that under this proposed payment methodology, home infusion providers will no longer be able to care for Medicare patients in their home.
The Centers for Medicare and Medicaid Services (CMS) recognizes the utilization of acute care drugs in the home infusion setting often results in an earlier hospital discharge and reduced healthcare costs. Access to home infusion therapy providers is critical to facilitate these healthcare transitions. (Medicare Prescription Drug Benefit Manual, Chapter 6, Section 10.11).
NASP respectfully requests that the Senate remove Section 5004 from the Act to ensure home infusion providers can continue to provide personalized, safe, and cost effective treatment to Medicare patients.
About National Association of Specialty Pharmacy (NASP)
NASP (www.naspnet.org) is the only national association for all stakeholders in the specialty pharmacy industry. The core mission of NASP is to provide continuing education programs to pharmacists and other healthcare professionals working in specialty pharmacy, a growing pharmacy discipline that dispenses and manages specialized medications for chronic, rare, and/or complex conditions. NASP members include specialty pharmacies, integrated health systems, pharmaceutical and biotechnology manufacturers, healthcare payers, GPOs, wholesale drug distributors, and technology and other vendors. To learn more, please visit: www.naspnet.org. Media contact: firstname.lastname@example.org