Joe Fiandra Access to Home Infusion Act of 2025
- Bill Number
- H.R. 4993
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-12-10: Ordered to be Reported in the Nature of a Substitute (Amended) by the Yeas and Nays: 41 - 0.
- Last Updated
- 2026-02-05T17:34:35Z
AI-Generated Summary
Summary of H.R. 4993: Joe Fiandra Access to Home Infusion Act of 2025
Purpose
This legislation aims to expand Medicare coverage under title XVIII of the Social Security Act for external infusion pumps and certain non-self-administrable home infusion drugs. It seeks to allow these items to qualify for home use even if they do not currently meet standard requirements for durable medical equipment.
Key Provisions
- Effective Date: The changes apply starting with the first calendar quarter one year after the bill's enactment.
- Criteria for Coverage: An external infusion pump and associated supplies or drugs qualify for Medicare coverage in the home if:
- The Food and Drug Administration-approved prescribing information requires administration by or under the supervision of a health care professional.
- A qualified home infusion therapy supplier (a provider authorized to deliver such services) administers or supervises the treatment safely in the patient's home.
- The drug is infused at least 12 times per year, either intravenously, subcutaneously, or at rates that necessitate an external pump (as determined by the Secretary of Health and Human Services).
- Patient Notification: The Secretary of Health and Human Services must ensure patients receive information on cost-sharing amounts for home infusion therapy compared to other care settings.
Significant Changes to Existing Law
- Amends section 1861(n) of the Social Security Act to create an exception to the "appropriate for use in the home" rule for durable medical equipment (defined in 42 CFR 414.202).
- This overrides prior regulatory limits that prevented coverage for certain pumps and drugs in home settings, broadening access beyond current Medicare rules for infusion services.
Potential Impacts
- On Government Agencies: Increases administrative responsibilities for the Centers for Medicare & Medicaid Services (CMS) in verifying supplier qualifications, processing claims, and providing cost-sharing notifications; may raise overall Medicare spending on infusion services.
- On Citizens: Improves access for Medicare beneficiaries needing frequent professional-administered infusions at home, potentially reducing hospital or clinic visits while requiring awareness of out-of-pocket costs.
- On International Relations: No direct effects identified.
Main Stakeholders Affected
- Medicare beneficiaries requiring non-self-administrable infusion drugs (such as those for chronic conditions).
- Home infusion therapy suppliers and qualified providers who deliver and supervise these services.
- Health care professionals involved in prescribing and overseeing infusions.
- The Department of Health and Human Services and CMS, responsible for implementation and oversight.
Notable Legal, Constitutional, or Political Implications
- Legal: Represents a targeted amendment to the Social Security Act, redefining eligibility for durable medical equipment coverage without altering broader constitutional authority over federal health programs.
- Constitutional: No significant issues noted, as this falls within Congress's established powers to regulate Medicare.
- Political: The bill is named after an individual (Joe Fiandra), suggesting advocacy ties; it addresses gaps in home-based care but could influence debates on Medicare expansion and cost controls.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Fitzpatrick, Brian K. [R-PA-1]
Cosponsors (6)
Rep. Dunn, Neal P. [R-FL-2], Rep. Soto, Darren [D-FL-9], Rep. Vindman, Eugene Simon [D-VA-7], Rep. Gottheimer, Josh [D-NJ-5], Rep. Ross, Deborah K. [D-NC-2], Rep. Lawler, Michael [R-NY-17]
Recent Actions
- 2025-12-10: Ordered to be Reported in the Nature of a Substitute (Amended) by the Yeas and Nays: 41 - 0.
- 2025-12-10: Committee Consideration and Mark-up Session Held
- 2025-08-19: 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.
- 2025-08-19: 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.
- 2025-08-19: Introduced in House
- 2025-08-19: Introduced in House
Bill Versions
- Joe Fiandra Access to Home Infusion Act of 2025 — issued 2025-08-19 — PDF (3 pages)