(3) 24/7 availability of pharmacist professional 
services such as assessments, drug preparation and 
compounding, dispensing, clinical monitoring, ad-
ministrative, and education; and 
(4) 24/7 availability of nursing services (when 
not provided as part of a home health episode). 
(c) QUALIFIED PROVIDERS.—Provided by a qualified 
home infusion therapy services supplier as defined in sec-
tion 1861(iii)(3)(C) of this Act. 
(d) ELIGIBLE INFUSION DRUGS.—Eligible part B 
and part D Infusion Drugs are defined as parenteral 
drugs or biologics administered through intravenous, 
intrathecal, intra-arterial, or subcutaneous access device, 
except— 
(1) drugs and biologics on the self-administered 
drug list; and 
(2) drugs and biologics covered under Part B 
Durable Medical Equipment, Prosthetics, Orthotics 
and Supplies (DMEPOS). 
(e) CURRENT OR FUTURE INFUSION DRUGS.—Pro-
vided, nothing in this section shall be construed to change 
the coverage status of any current or future infusion drugs 
that meet the definition of a covered part D drug as de-
fined at section 1860D–2(e) and which are paid under 
Medicare part D. 
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(f) REFERRING
PROVIDERS.—Patients must be 
under the care of a physician, nurse practitioner, or physi-
cian assistant. 
(g) SAFETY AND QUALITY.—Consistent with stand-
ards of care found within commercial, Medicare Advan-
tage, and State Medicaid programs with regard to sterile 
preparation of the drug to a final, useable form; timeliness 
of initiation of care; billing of drugs, items, and pharmacy 
services by a single entity; performing periodic assess-
ments of patient satisfaction and collection and evaluation 
of quality outcome data; and maintaining a consolidated 
patient record of services provided in accordance with the 
plan of care. 
(h)(1) REIMBURSEMENT.—A per infusion day pay-
ment is established and defined as ‘‘a payment for the 
date on which a drug was administered to the individual 
at home (regardless of whether a skilled professional was 
physically present in the home of such individual on such 
date)’’. 
(2) MARKET RATES.—Such payment may be based 
on a market analysis of rates paid for home infusion sup-
plies and services by the commercial sector and Medicare 
Advantage programs. 
(3) PAYMENT ELIGIBILITY.—Nothing shall prevent a 
home infusion supplier from being paid a per infusion day 
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payment when a qualified home health agency provides the 
nursing services for the infusion therapy under the part 
A home health benefit. 
SEC. 4. ESTABLISHING PAYMENT FOR STAFF-ASSISTED 
HOME DIALYSIS. 
(a) IN GENERAL.—Section 1881(b)(14) of the Social 
Security Act (42 U.S.C. 1395rr(b)(14)) is amended by 
adding at the end the following new subparagraph: 
‘‘(J)(i) For services furnished on or after 
the date which is 1 year after the date of the 
enactment of this subparagraph which are staff- 
assisted home dialysis (as defined in clause 
(iv)(III)), the Secretary shall increase the single 
payment that would otherwise apply under this 
paragraph for renal dialysis services furnished 
to new and respite individuals in accordance 
with the payment system established under 
clause (iii) by qualified providers. 
‘‘(ii)(I) Subject to subclause (II), staff-as-
sisted home dialysis may only be furnished dur-
ing— 
‘‘(aa) with respect to an individual de-
scribed in subclause (iv)(I)(aa), one 90-day 
period which may be renewed up to two 
30-day periods; and 
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‘‘(bb) with respect to an individual de-
scribed in subclause (iv)(I)(bb) and not-
withstanding whether such an individual 
receives any respite care under part A, any 
30-day period. 
‘‘(II) Notwithstanding the limits described 
in subclause (I), staff-assisted home dialysis 
may be furnished for as long as the Secretary 
determines appropriate to an individual who— 
‘‘(aa) is blind; 
‘‘(bb) has a cognitive or neurological 
impairment 
(including 
a 
stroke, 
Alz-
heimer’s, dementia amyotrophic lateral 
sclerosis, or any other impairment deter-
mined by the Secretary); or 
‘‘(cc) has any other illness or injury 
that reduces mobility (including cerebral 
palsy, spinal cord injuries, or any other ill-
ness or injury determined by the Sec-
retary). 
‘‘(iii) The Secretary shall establish a pro-
spective payment system through regulations to 
determine the amounts payable to qualified pro-
viders for staff-assisted home dialysis. In estab-
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lishing such system, the Secretary may con-
sider— 
‘‘(I) the costs of furnishing staff-as-
sisted home dialysis; 
‘‘(II) consultations with dialysis pro-
viders, dialysis patients, private payers, 
and MA plans; 
‘‘(III) payment amounts for similar 
items and services under parts A and B; 
and 
‘‘(IV) payment amounts established 
by MA plans under part C, group health 
plans, and health insurance coverage of-
fered by health insurance issuers. 
‘‘(iv) In this subparagraph: 
‘‘(I) The term ‘new and respite indi-
vidual’ means an individual described in 
subsection (a) who is either— 
‘‘(aa) initiating either peritoneal 
or home hemodialysis; or 
‘‘(bb) receiving home dialysis and 
is unable to self-dialyze due to illness, 
injury, caregiver issues, or other tem-
porary circumstances. 
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