Situation Report | November 9, 2020
The U.S. Centers for Medicare and Medicaid Services updated the enrollment policies for home infusion therapy (HIT) suppliers. See Transmittal 10434/Change Request (CR) 11954.
CMS timed this information to follow its issuance of the 2021 home health payment rule (last week), where the home infusion therapy benefit provisions are finalized. See our memo on the rule here.
The new transmittal/CR updates the enrollment instructions in Chapter 10 of the Medicare Program Integrity Manual, Publication 100-08.
This updated benefit covers the professional services, including nursing services, furnished in accordance with the plan of care, patient training and education (not otherwise covered under the durable medical equipment benefit), remote monitoring, and monitoring services for the provision of home infusion therapy and home infusion drugs furnished by a qualified HIT supplier.
Qualified suppliers include a pharmacy, physician, or other provider of services or supplier licensed by the state in which supplies or services are furnished. A number of other requirements apply. Providers must obtain a Taxpayer Identification Number and National Provider Identifier, undergo an application and screening process, get accredited, and revalidate every five years (consistent with other provider types).
Per CMS’s Transmittal, providers can begin enrolling as a supplier on or after November 1, 2020 by submitting CMS Form 855-B and paying an enrollment fee.
Some providers have expressed concerns about the timeframe for processing the applications, given that the Medicare home health benefit will no longer cover certain home infusion therapy services in less than two months — beginning January 1, 2021 — when the new benefit goes into effect.
Prior to approval and processing of Form 855-B, applicants must also be accredited by an approved accrediting organization for home infusion therapy services. Applicants will be processed under the limited-risk category. CMS’s Transmittal/CR names approximately six recognized accrediting organizations.