Joe Fiandra Access to Home Infusion Act of 2025
The Joe Fiandra Access to Home Infusion Act of 2025 would expand Medicare coverage to include external infusion pumps and certain home infusion drugs that are not currently considered appropriate for home use under existing durable medical equipment (DME) rules. Starting in the first calendar quarter after one year from enactment, such pumps and associated home infusion drugs could be covered if they meet three conditions: (1) FDA-approved labeling for the drug instructs administration by or under supervision of a health care professional; (2) a qualified home infusion therapy supplier administers or supervises the drug in the patient’s home; and (3) the drug is prescribed for at least 12 administrations per year (or for infusion rates that would require an external infusion pump, as determined by the Secretary). The bill also requires the Secretary of Health and Human Services to notify patients about the cost-sharing differences between home infusion therapy and other care settings. In short, the measure aims to make home-based, professional-supervised infusion therapies more accessible under Medicare, subject to safety and use requirements.
Key Points
- 1Expands Medicare coverage to include external infusion pumps and non-self-administerable home infusion drugs that meet specific criteria, effectively broadening what can be paid for as home infusion therapy.
- 2Effective date: Beginning with the first calendar quarter after the date that is one year after enactment.
- 3Eligibility criteria (three-part test):
- 4Relationship to existing DME rules: The covered pumps and drugs would be treated as meeting the “home use” DME requirement if the above criteria are satisfied.
- 5Cost-sharing transparency: The Secretary must ensure patients receive information about the cost-sharing differences between home infusion therapy and other infusion settings under Medicare.