Home infusion of intravenous immunoglobulin therapy (IVIG) or subcutaneous therapy (SCIG) is safer and more convenient than outpatient or in-hospital treatment for patients with primary immune deficiency and reduces costs for payers.
However, until recently there were limited at-home treatment options available to Medicare beneficiaries with primary immune deficiency. Medicare Part B regulations only allowed patients to be reimbursed for the medication and not the necessary ancillary supplies and nursing care required to safely administer IVIG in the home. This forced patients to obtain their treatment at an outpatient treatment setting which is less convenient, and does not offer the same high standards or cost savings as at-home treatment.
A Changing Landscape and Accredo's Role
The gap in Medicare Part B coverage is starting to close thanks to a new regulation, championed by the Immune Deficiency Foundation and the primary immunodeficiency community. Accredo is helping demonstrate the benefits of home infusion services for IVIG through a three-year project instituted as part of the new regulation.
Up to 4,000 Medicare beneficiaries (the program maximum) that prefer to receive their IVIG treatment at home can enroll in this pilot program. Accredo patients enrolled in this pilot will then be able to receive their treatment at home with clinical support from Accredo’s nursing staff, who have extensive experience and specialized training in primary immune deficiency.
Eligibility Requirements for Participation
Patient enrollment for the three-year demonstration project began in September 2014 and will continue until the program maximum of 4,000 has been reached. To be eligible, patients must:
- Be enrolled in Medicare Part A and Part B and not enrolled in a Medicare Advantage plan
- Be diagnosed with a primary immunodeficiency disorder
- Be receiving IVIG treatment and want to switch to a home setting, or be on SCIG treatment and want to switch to IVIG
- Complete the application and have their physician sign it
Patients will be informed of their start date in the demonstration project once the application is approved by Medicare. Participation in the IVIG at-home program will not affect Medicare benefits, and patients are free to withdraw from the program at any time.
The goal of the program is to ensure that new beneficiaries do not lose their preferred at-home treatment options when they transition to Medicare, and that they are able to continue receiving the support of highly specialized clinicians like Accredo’s specialists.
For more information visit the Centers for Medicare and Medicaid Services pilot site.
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