Note: Parenteral (IV) and enteral (tube feeding) nutrition are covered under Medicare Part B for home
use, but infusion treatments such as IV antibiotics, hydration, and some cancer medications may not be.
The medicines are generally covered by Medicare Part D. However, there is currently no coverage for the
supplies, professional services, and equipment needed for these medicines to be infused in the home. The
Medicare Home Infusion Site of Care Act would allow coverage of the related supplies, services, and
equipment under Medicare Part B, thus enabling the current Part D coverage of infusion drugs to become
meaningful for Medicare beneficiaries.
We urge you to personalize this letter by adding any personal details or examples that may seem relevant.
DATE
The Honorable [Representative Name]
United States House of Representatives
ADDRESS
Washington, DC 20515
Dear [Name of Representative]
Thank you for your continued leadership on health care issues. I’m writing to you today as a constituent
and as an advocate for the Oley Foundation to urge you to support the Medicare Home Infusion Site of
Care Act of 2015 (H.R. 605), which was introduced on January 28, 2015 by Representatives Engel (DNY) and Tiberi (R-OH). This bill will fix an unintended gap in Medicare coverage that is contributing to
the unnecessary spending of valuable Medicare dollars to treat patients needing intravenous medications
in hospitals and nursing homes rather than in the cost-effective safety and comfort of their own homes.
[Insert brief paragraph about your personal story here.]
Medicare beneficiaries with serious infections, cancer, congestive heart failure, and other life-threatening
conditions are often treated with infusion therapy, which involves the administration of drugs into the
bloodstream via a needle or catheter. Unlike dispensing of oral medications, infusion requires specialized
equipment, supplies, patient education, monitoring and other professional services. Infusion therapy is
fully covered by Medicare in hospitals, skilled nursing facilities, hospital outpatient departments, and
physician offices, but not in the home, despite evidence that infusion treatments in the home are an
excellent and proven way to improve quality of care at much lower costs.
The policy included in legislation was recently studied by the health care policy firm Avalere Health,
which analyzed the impact on Medicare program expenditures from a portion of patients shifting their
infusion treatment setting from hospitals, nursing homes, or physician offices to the home. Avalere found
that there would be an estimated savings to the Medicare program for the 10-year period from 2015 to
2024 of 12.6 percent, or $80 million. These estimates are conservative. For example, Avalere did not
calculate the additional cost savings that could result from the avoidance of hospital stays and hospitalacquired infections.
The Medicare fee-for-service program is virtually the only payer in the United States that does not fully
recognize the clinical and cost benefits of providing infusion drug therapy to patients in their homes. H.R.
605 would remedy this by ensuring that Medicare beneficiaries can receive infusion treatments in the
home.
I urge you to cosponsor the Medicare Home Infusion Site of Care Act of 2015 (H.R. 605). Please contact
Heidi Ross with Rep. Engel at Heidi.Ross@mail.house.gov or 5-2464 or Whitney Daffner with Rep. Pat
Tiberi at Whitney.Daffner@mail.house.gov or 5-5355 to cosponsor or if you have any questions. If you
need examples of how other patients may be affected by the current lack of coverage, please contact the
Oley Foundation, (518) 262-5079.
Please maintain Medicare solvency while improving the quality of care for Medicare recipients. I look
forward to your written response on this matter.
Thank you for your time and your consideration of this request.
Sincerely,
cc: Joan Bishop, The Oley Foundation