S. 1058: Preserving Patient Access to Home Infusion Act
Sponsor
Mark Warner
Democrat · VA
Bill Progress
Latest Action · Mar 13, 2025
Read twice and Referred to Finance. for review
Home infusion saves Medicare money — but the payment rules don't reflect it
Why it matters
For patients needing IV antibiotics, biologics, or other infusion drugs, this is about whether treatment can happen safely at home instead of forcing unnecessary clinic visits or making providers eat uncompensated costs. Home infusion pharmacies and suppliers are the clear winners because the bill recognizes the behind-the-scenes work Medicare has underpaid or ignored, while Medicare would take on broader payment obligations, including for certain non-pump antibacterial drugs and for each day a drug is administered even without an in-person visit. The bill also broadens who can manage the plan of care by letting nurse practitioners and physician assistants sign off, which could ease access bottlenecks in communities with limited physician availability.
S1058 Legislative Journey
Committee Action
Mar 13, 2025
Read twice and referred to the Committee on Finance.
About the Sponsor
Mark Warner
Democrat, VA · 17 years in Congress
Committees: Senate Select Committee on Intelligence, Banking, Housing, and Urban Affairs, Rules and Administration
View full profile →
Cosponsors (1)
This bill has 1 cosponsor: 1 Republican. Cosponsors represent 1 state: South Carolina.
Committee Sponsors
12 Democrats across this committee haven't cosponsored yet. Mobilize their constituents
What laws does S. 1058 change?
2 changes
Sections Amended
Section 1834(u) of Social Security Act (42 U.S.C. 1395m(u))
adding at the end the following new paragraph: ``(8) Clarification on billing for a specified non-pump drug or biological
Section 1834(a) of Social Security Act (42 U.S.C. 1395m(a))
adding at the end the following new paragraph: ``(23) Special payment rule for items and supplies furnished in conjunction with home infusion therapy
S. 1058 Quick Facts
- Committee
- Finance
- Chamber
- Senate
- Policy
- Health
- Introduced
- Mar 13, 2025
Read twice and Referred to Finance. for review
Mar 13, 2025
S. 1058 Common Questions
How much would Medicare pay for home infusion when no nurse visits the home under S.1058?
Under the Preserving Patient Access to Home Infusion Act, Medicare would pay 50% of the amount that would apply if the supplier were physically present in the home (Section 2(b)(4)).
How many hours of infusion does the home infusion payment rate assume from 2026 to 2030?
According to S.1058 Section 2(b)(3)(B), for therapy furnished from January 1, 2026 through December 31, 2029, the payment amount must reflect 5 hours of infusion per calendar day.
Can Medicare pay home infusion providers for each calendar day a drug is administered even if they are not in the home?
Yes. Under the Preserving Patient Access to Home Infusion Act, payment is tied to each day the drug was administered, regardless of whether the supplier was physically present in the home (Section 2(b)(2)).
Can nurse practitioners and physician assistants approve a Medicare home infusion plan of care?
Yes. Under the Preserving Patient Access to Home Infusion Act, nurse practitioners and physician assistants could establish and review home infusion plans of care, along with physicians (Section 2(c)).
Does S.1058 let Medicare cover home infusion services for IV antibiotics that are not given through a pump?
Yes. According to S.1058 Section 3, Medicare payment for home infusion items and services would apply to specified non-pump IV antibacterial drugs, even if the drug itself is not payable under Part B.
Which non-pump drugs would qualify for home infusion services under the Preserving Patient Access to Home Infusion Act?
Under Section 3, the bill covers intravenously administered drugs not delivered through a DME pump if they are antibacterial, antifungal, or antiviral under United States Pharmacopeia categories.
Does Medicare home infusion payment under S.1058 include pharmacy services and drug compounding?
Yes. Under the Preserving Patient Access to Home Infusion Act, home infusion therapy services would include pharmacy services, assessments, drug preparation and compounding, coordination, and documentation (Section 2(a)).
Can Medicare pay for home infusion services even if the non-pump drug itself is not covered under Part B?
Yes. According to S.1058 Section 3(b), payment for home infusion items and services would be made for specified non-pump drugs or biologicals regardless of whether the drug itself is payable under Medicare Part B.
What home infusion supplies would Medicare stop paying separately for under S.1058?
Section 4 would bar separate payment for items furnished the same day as paid home infusion therapy, including tubing, catheters, dressings, needles, syringes, and HCPCS codes A4221, A4222, and K0552.
When would the Preserving Patient Access to Home Infusion Act take effect for Medicare services?
Under Sections 2(d) and 3(c), the bill would apply to Medicare items and services furnished on or after January 1, 2026.
Based on S. 1058 bill text
S. 1058 Bill Text
“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.”
Source: U.S. Government Publishing Office
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