Access to home infusion for non-pump drugs and biologicals

(a) Modification of definition of home infusion drug Section 1861(iii)(3) of the Social Security Act (42 U.S.C. 1395x(iii)(3)) is amended— (1) in subparagraph (C), by inserting and, in the case of a drug or biological other than a specified non-pump drug or biological (as defined in subparagraph (E)), before through; and (2) by adding at the end the following new subparagraph: (E) The term specified non-pump drug or biological means a drug or biological that— (i) is administered intravenously but not through a pump that is an item of durable medical equipment (as defined in subsection (n)); and (ii) is an antibacterial, antifungal, or antiviral (as categorized by the United States Pharmacopeia).. (b) Clarification on billing Section 1834(u) of the Social Security Act (42 U.S.C. 1395m(u)) is amended by adding at the end the following new paragraph: (8) Clarification on billing for a specified non-pump drug or biological In the case of a qualified home infusion supplier (as defined in section 1861(iii)(3)(D)) that furnishes items and services described in subparagraphs (A) and (B) of section 1861(iii)(2) in coordination with the furnishing of a home infusion drug (as defined in section 1861(iii)(3)(C)) that is a specified non-pump drug or biological (as defined in section 1861(iii)(3)(E)) where the method of infusion utilized in furnishing such drug or biological does not involve a pump that is an item of durable medical equipment, payment under this subsection for the items and services described in subparagraphs (A) and (B) of section 1861(iii)(2) shall be made with respect to such drug or biological regardless of whether such drug or biological so furnished is payable under this part.. (c) Effective date The amendments made by this section shall apply with respect to items and services furnished on or after January 1, 2026.