The following press release is re-printed with permission from the Alpha-1 Foundation.
(April 1, 2020) Alphas on Medicare have a new Choice!
The Centers for Medicare and Medicaid Services Announced Sweeping Regulatory Changes that include an option for Alpha-1 patients to receive home infusions. These temporary changes will ensure that patients have access to care while remaining safely at home.
On Monday March 30, 2020, the Centers for Medicare & Medicaid Services (CMS) issued temporary regulatory waivers and new rules amid concerns for the US Healthcare system during the COVID-19 pandemic. Within these regulations is a big victory for individuals with Alpha-1 Antitrypsin Deficiency who receive augmentation therapy. The choice of home infusions is now available for Alphas that usually receive infusions in a hospital or physician office setting.
Very early in the pandemic Alphas contacted the Alpha-1 Foundation to express concerns about receiving their treatments in a facility where people might be sick with COVID-19. Ensuring the safety and health of Alphas is a primary concern for the Foundation during this pandemic. “We heard the fears expressed by community members about going into a high risk setting like a hospital for their weekly infusions. People were considering skipping infusions; going every other week; or not at all. We worked fast to find a solution that would give Alphas choice and flexibility.” Says Miriam O’Day, the Foundation’s President and CEO.
O’Day contacted Seema Verma, Administrator of CMS to plead for a home infusion option for patients during this pandemic. “We also took our issue to Capitol Hill as the COVID-19 Stimulus Package was being negotiated. It was inspirational to see how many patients joined us in our advocacy efforts by reaching out to their Members of Congress. It made a difference,” says O’Day.
This temporary regulatory change will allow patient choice for Medicare beneficiaries to be able to access home infusions. Medicare Part B and Part D can be billed for home infusions. Patients should be aware about how their infusions will be billed. You do not have to go off of Medicare Part B at this time in order to access home infusions.
The Alpha-1 Foundation strongly recommends that Alphas that have Medicare Part B remain on this plan because it can be more expensive for infusions through Medicare Part D.
Patients need to be their own best advocate for their health care treatments by having transparent conversations with your health care providers about this choice and its cost. In order to receive infusions at home, Alphas and their physicians need to understand the choice and nuances of billing Medicare correctly. We encourage patients to understand the costs associated with switching from Medicare Part B to Medicare Part D if this is being recommended. Talk to your provider, specialty pharmacy and/or home care infusion company and have a transparent conversation about the costs.
Click on the link below to read the Alpha-1 Foundation’s full press release, which includes links to additional resources.