For Immediate Release
April 1, 2020 -Alphas on Medicare have a new Choice!
The Centers for Medicare and Medicaid Services Announced Sweeping Regulatory Changes that include an option for Alpha-1 patients to receive home infusions. These temporary changes will ensure that patients have access to care while remaining safely at home.
On Monday, March 30, 2020, the Centers for Medicare & Medicaid Services (CMS) issued temporary regulatory waivers and new rules amid concerns for the US Healthcare system during the COVID-19 pandemic. Within these regulations is a big victory for individuals with Alpha-1 Antitrypsin Deficiency who receive augmentation therapy. The choice of home infusions is now available for Alphas that usually receive infusions in a hospital or physician office setting.
Very early in the pandemic Alphas contacted the Alpha-1 Foundation to express concerns about receiving their treatments in a facility where people might be sick with COVID-19. Ensuring the safety and health of Alphas is a primary concern for the Foundation during this pandemic. “We heard the fears expressed by community members about going into a high risk setting like a hospital for their weekly infusions. People were considering skipping infusions; going every other week; or not at all. We worked fast to find a solution that would give Alphas choice and flexibility,” says Miriam O’Day, the Foundation’s President and CEO.
O’Day contacted Seema Verma, Administrator of CMS to plead for a home infusion option for patients during this pandemic. “We also took our issue to Capitol Hill as the COVID-19 Stimulus Package was being negotiated. It was inspirational to see how many patients joined us in our advocacy efforts by reaching out to their Members of Congress. It made a difference,” says O’Day.
This temporary regulatory change will allow patient choice for Medicare beneficiaries to be able to access home infusions. Medicare Part B and Part D can be billed for home infusions. Patients should be aware about how their infusions will be billed. You do not have to go off of Medicare Part B at this time in order to access home infusions.
The Alpha-1 Foundation strongly recommends that Alphas that have Medicare Part B remain on this plan because it can be more expensive for infusions through Medicare Part D.
Patients need to be their own best advocate for their health care treatments by having transparent conversations with your health care providers about this choice and its cost. In order to receive infusions at home, Alphas and their physicians need to understand the choice and nuances of billing Medicare correctly. We encourage patients to understand the costs associated with switching from Medicare Part B to Medicare Part D if this is being recommended. Talk to your provider, specialty pharmacy and/or home care infusion company and have a transparent conversation about the costs.
The Foundation is working to develop a comprehensive fact sheet for physicians and patients to explain how the temporary benefit can be accessed and billed. This resource will be available shortly on our designated COVID-19 page.
For more information on the CMS COVID-19 waivers and guidance, and the Interim Final Rule, please visit the CMS COVID-19 flexibilities webpage: https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers.
These actions, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Coronavirus Task Force efforts. To keep updated on work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov.
For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.
Important terms used in this press release regarding Medicare:
There are four parts of Medicare: Part A, Part B, Part C, and Part D. Part A provides inpatient/hospital coverage. Part B provides outpatient/medical coverage. Part C offers an alternate way to receive your Medicare benefits. Part D provides prescription drug coverage.
If you’re not sure if you have Part A or Part B, look on your red, white, and blue Medicare card. If you have Part A, “Hospital (Part A)” is printed on the lower left corner of your card. If you have Part B, “Medical (Part B)” is printed on the lower left corner of your card.
About the Alpha-1 Foundation
The Alpha-1 Foundation, founded in 1995, is committed to finding a cure for Alpha-1 Antitrypsin Deficiency (Alpha-1) and to improving the lives of people affected by Alpha-1 worldwide. The Foundation has invested over $76 million to support Alpha-1 research and programs at 116 institutions in North America, Europe, the Middle East, and Australia.
For more information, visit www.alpha1.org.
Contact: Jeanne Kushner
Director of Communications & Public Affairs