Joe Fiandra Access to Home Infusion Act of 2025
- Sponsor
- Rep. Fitzpatrick, Brian K. [R-PA-1]
- Committees
- Ways and Means Committee (primary)
- Last action
- Dec 10, 2025
Bottom line
The Joe Fiandra Access to Home Infusion Act of 2025 aims to enhance Medicare beneficiaries' access to necessary home infusion therapies by expanding coverage for specific pumps and drugs, while also promoting cost transparency for patients.
What it actually does
This bill amends title XVIII of the Social Security Act to expand Medicare coverage for external infusion pumps and associated non-self-administrable home infusion drugs and supplies. It specifies criteria under which these items will be covered, particularly when professional administration is required and infusions occur frequently or necessitate an external pump, even if they do not strictly meet existing durable medical equipment requirements for home use. The bill also mandates patient notification regarding cost-sharing differences for home infusion therapy compared to other care settings.
Proponents argue
Supporters argue that this bill addresses a critical gap in Medicare coverage, allowing patients to receive essential, medically necessary infusion treatments in the comfort and safety of their homes. They contend that this expansion will improve patient quality of life, potentially reduce healthcare costs by shifting care from more expensive institutional settings, and ensure that beneficiaries are not forced into inpatient care solely due to a lack of home coverage.
Opponents contend
Critics might express concerns that expanding Medicare coverage for these services could lead to increased federal expenditures without sufficient cost controls or oversight. They may also raise questions about the potential for fraud, waste, and abuse in expanded home-based care services, which can be more challenging to monitor than facility-based care.
The bill is very short and clearly written, making it highly accessible for a reader to understand its provisions and implications quickly.
Section 2(a), amending Section 1861(n) of the Social Security Act
Expansion of Medicare Coverage for External Infusion Pumps and Non-Self-Administrable Home Infusion Drugs
This provision modifies Medicare law to ensure that external infusion pumps and certain associated home infusion drugs and supplies are covered under Medicare, even if they do not strictly meet the existing 'appropriate for use in the home' requirement for durable medical equipment. Coverage applies if the drug's prescribing information requires administration by a healthcare professional, and if the drug is infused at least 12 times per year intravenously or subcutaneously, or at infusion rates necessitating an external pump. This change is effective one year after the bill's enactment.
Supporters argue
Supporters argue that this provision closes a critical gap in Medicare coverage, allowing patients to receive medically necessary infusion treatments in the comfort and safety of their homes. This can lead to better health outcomes, greater patient satisfaction, and potentially lower overall healthcare costs by avoiding more expensive institutional care.
Critics contend
Critics might express concern that expanding coverage could lead to increased Medicare spending without sufficient cost controls or oversight. They may also worry about the potential for new avenues of fraud or inappropriate utilization of services in the expanded home care setting.
Tradeoffs
This provision balances the desire to provide comprehensive home-based care for patients with the need to manage Medicare expenditures and ensure appropriate utilization of services. It aims to improve patient convenience and potentially reduce institutional care costs, but introduces new costs for home services.
Section 2(b)
Patient Notification of Cost Sharing for Home Infusion Therapy
This provision mandates that the Secretary of Health and Human Services must ensure that Medicare patients are notified of the cost-sharing differences when they choose home infusion therapy compared to receiving infusion drugs in other applicable care settings under the Medicare program.