I 
118TH CONGRESS 
1ST SESSION H. R. 4104 
To amend title XVIII of the Social Security Act to clarify congressional 
intent and preserve patient access to home infusion therapy under the 
Medicare program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 14, 2023 
Mr. BUCHANAN (for himself, Mrs. DINGELL, Mrs. HARSHBARGER, and Ms. 
SEWELL) introduced the following bill; which was referred to the Com-
mittee 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 
A BILL 
To amend title XVIII of the Social Security Act to clarify 
congressional intent and preserve patient access to home 
infusion therapy under the Medicare program, and for 
other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Preserving Patient Ac-
cess to Home Infusion Act’’. 
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SEC. 2. PRESERVATION OF PATIENT ACCESS TO HOME IN-
FUSION THERAPY UNDER MEDICARE PRO-
GRAM. 
(a) INCLUSION OF PHARMACY SERVICES.—Section 
1861(iii)(2) of the Social Security Act (42 U.S.C. 
1395x(iii)(2)) is amended— 
(1) in subparagraph (A), by inserting ‘‘and 
pharmacy services’’ after ‘‘nursing services’’; and 
(2) in subparagraph (B), by inserting ‘‘, assess-
ments, drug preparation and compounding, coordi-
nation and documentation of infusion therapy serv-
ices in the plan of care’’ after ‘‘subsection (n))’’. 
(b) PAYMENT.—Section 1834(u)(1)(A) of the Social 
Security Act (42 U.S.C. 1395m(u)(1)(A)) is amended— 
(1) in clause (i), by striking ‘‘clause (iii)’’ and 
inserting ‘‘clauses (iii) and (iv)’’; 
(2) in clause (ii) by inserting after the first sen-
tence the following new sentence: ‘‘For purposes of 
the previous sentence, a reference to payment to a 
qualified home infusion therapy supplier for an infu-
sion drug administration calendar day in the home 
of such individual shall refer to payment for each 
day on which such a drug was administered to the 
individual (regardless of whether a qualified home 
infusion therapy supplier was physically present in 
the home of such individual on such date).’’; and 
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(3) by adding at the end the following new 
clause: 
‘‘(iv) SPECIAL RULE WHEN A QUALI-
FIED HOME INFUSION THERAPY SUPPLIER 
NOT PHYSICALLY PRESENT IN THE INDI-
VIDUAL’S
HOME.—In the case where a 
qualified home infusion therapy supplier is 
not physically present in the individual’s 
home on the day the home infusion drug is 
administered to the individual, the single 
payment amount under this subsection for 
items and services described in clause (i) 
furnished on such day to such individual 
shall be an amount equal to 50 percent of 
the amount that would have applied under 
this subsection for such items and services 
if such a supplier had been physically 
present.’’. 
(c) PERMITTING NURSE PRACTITIONERS AND PHYSI-
CIAN ASSISTANTS TO ESTABLISH AND REVIEW A HOME 
INFUSION PLAN OF CARE.—Section 1861(iii)(1)(B) of the 
Social Security Act (42 U.S.C. 1395x(iii)(1)(B)) is 
amended by striking ‘‘physician (as defined in subsection 
(r)(1)) and is periodically reviewed by a physician’’ and 
inserting ‘‘physician (as defined in subsection (r)(1)) or 
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a nurse practitioner or physician assistant (as those terms 
are defined in subsection (aa)(5)) and is periodically re-
viewed by a physician, nurse practitioner, or physician as-
sistant’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to items and services 
furnished on or after January 1, 2024. 
Æ 
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