Legislation
Section 5012 of the 21st Century Cures Act
On December 13, 2016, the 21st Century Cures Act (the Cures Act) was enacted into law. Section 5012 of this new law amended sections 1861(s)(2) and 1861(iii) of the Act, and established a new Medicare home infusion therapy benefit. The Medicare home infusion therapy benefit is for coverage of home infusion therapy-associated professional services for certain drugs and biologicals administered intravenously, or subcutaneously through a pump that is an item of DME, effective January 1, 2021. Section 1861(iii)(2) of the Act defines home infusion therapy to include the following items and services: the professional services (including nursing services), furnished in accordance with the plan, training and education (not otherwise included in the payment for the DME), remote monitoring, and other monitoring services for the provision of home infusion therapy furnished by a qualified home infusion therapy supplier in the patient’s home.
Section 4134 of the Consolidated Appropriations Act, 2023
On December 19, 2022, the Consolidated Appropriations Act, 2023 (the CAA, 2023) was enacted into law. Section 4134 of this new law amended section 1861(s)(2)(Z) of the Act to add the items and services (furnished on or after January 1, 2024) related to the administration of IVIG to the benefit category that provides coverage of the IVIG product in the home for treatment of primary immune deficiency diseases. A beneficiary must be receiving one of the IVIG derivatives specified under the LCD for IVIG (L-33610) in order to qualify to receive the items and services covered under section 1861(s)(2)(Z) of the Act.