119-hr4993

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4993 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 4993

To amend title XVIII of the Social Security Act to provide coverage of 
external infusion pumps and non-self-administrable home infusion drugs 
 under the Medicare program.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 August 19, 2025

 Mr. Fitzpatrick (for himself, Mr. Dunn of Florida, and Mr. Soto) 
 introduced the following bill; which was referred to the Committee on 
 Energy and Commerce, and in addition to the Committee on Ways and 
 Means, for a period to be subsequently determined by the Speaker, in 
 each case for consideration of such provisions as fall within the 
 jurisdiction of the committee concerned

_______________________________________________________________________

 A BILL

To amend title XVIII of the Social Security Act to provide coverage of 
external infusion pumps and non-self-administrable home infusion drugs 
 under the Medicare program.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Joe Fiandra Access to Home Infusion 
Act of 2025''.

SEC. 2. MEDICARE COVERAGE OF EXTERNAL INFUSION PUMPS AND NON-SELF-
 ADMINISTRABLE HOME INFUSION DRUGS.

    (a) In General.--

Section 1861

    (n) of the Social Security Act (42 
U.S.C. 1395x

    (n) ) is amended by adding at the end the following new 
sentence: ``Beginning with the first calendar quarter beginning on or 
after the date that is 1 year after the date of the enactment of this 
sentence, an external infusion pump and associated home infusion drug 
(as defined in subsection
            (iii) (3)
            (C) ) or other associated supplies 
that do not meet the appropriate for use in the home requirement 
applied to the definition of durable medical equipment under 

section 414.202 of title 42, Code of Federal Regulations (or any successor to 
such regulation) shall be treated as meeting such requirement if each 
of the following criteria is satisfied:
 ``

    (1) The prescribing information approved by the Food and 
 Drug Administration for the home infusion drug associated with 
 the pump instructs that the drug should be administered by or 
 under the supervision of a health care professional.
 ``

    (2) A qualified home infusion therapy supplier (as 
 defined in subsection
            (iii) (3)
            (D) ) administers or supervises 
 the administration of the drug or biological in a safe and 
 effective manner in the patient's home (as defined in 
 subsection
            (iii) (3)
        (B) ).
 ``

    (3) The prescribing information described in paragraph

    (1) instructs that the drug should be infused at least 12 times 
 per year--
 ``
        (A) intravenously or subcutaneously; or
 ``
        (B) at infusion rates that the Secretary 
 determines would require the use of an external 
 infusion pump.''.

    (b) Cost Sharing Notification.--The Secretary of Health and Human 
Services shall ensure that patients are notified of the cost sharing 
for electing home infusion therapy compared to other applicable 
settings of care for the furnishing of infusion drugs under the 
Medicare program.
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