The 21st Century Cures Act, which was signed into law on December 13, 2016, called for the creation of a bundled payment for providers that supply home infusion therapy services to Medicare beneficiaries. A requirement of the act stipulated that home infusion suppliers be accredited by an accrediting organization approved by the Centers for Medicare & Medicaid Services (CMS) in order to receive Medicare reimbursement.

Beginning January 1, 2021, all home infusion therapy suppliers must be accredited to receive Medicare reimbursement.

Yes, the Centers for Medicare & Medicaid Services (CMS) has recognized ACHC as a national accrediting organization for home infusion therapy suppliers. The decision gives ACHC deeming authority to conduct surveys that meet or exceed Medicare requirements, including new reimbursement rules mandated by the 21st Century Cures Act.

Each location will be required to have its own NPI and PTAN numbers. If home health and private duty nursing providers want to provide services and bill separately, they will need to apply for a Medicare Part B billing number in order to bill for the professional services provided in the client/patient’s home. This means that there will need to be individual accreditation for each location. CMS is still developing this process.

The Infusion Pharmacy (IRX) Accreditation Service centers around the pharmacy services of preparing, dispensing, and managing patients receiving infusion therapy in the home. Home Infusion Therapy Accreditation looks at the education, assessment, medication review, and development of the plan of care provided by a nurse or healthcare professional during the home visit.

No. Standards for our Infusion Pharmacy Accreditation Service will remain the same.

For current customers renewing their ACHC Accreditation, and all organizations that ACHC accredits before January 1, 2021, ACHC will conduct both on-site surveys and off-site audits on a percentage of renewing locations. For new ACHC customers, CMS will require that all locations receive an on-site survey beginning January 1, 2021.

An off-site audit will be conducted on a percentage of an organization’s renewing locations based on a methodology that takes into consideration:

• History of complaints with client/patient-related deficiencies.
• Risk potential as identified by performance improvement data.
• Infusion volume.
• Previous survey results.

New home infusion therapy suppliers will need to have serviced three clients/patients.  In rural areas, a new home infusion therapy supplier seeking accreditation will need to have serviced two clients/patients.

Yes. After the release of our new Home Infusion Therapy Accreditation Standards on November 1, 2019, ACHC will provide educational materials.

No, the supplier does not need to be a pharmacy. The supplier must be able to meet the provisions defined in the Social Security Act. The Social Security Act defines a supplier as:

Section 1861(iii)(3)(D)(i) of the Social Security Act defines a supplier as a pharmacy, physician, or other provider of services or supplier licensed by the State in which the pharmacy, physician, or provider of services or supplier furnishes items or services and that:

• Furnishes infusion therapy to individuals with acute or chronic conditions requiring administration of home infusion drugs;
• Ensures the safe and effective provision and administration of Home Infusion Therapy on a 7-day-a-week, 24-hour-a-day basis; and
• Is accredited by an organization designated by the Secretary pursuant to section 1834(u)(5).

A qualified home infusion therapy supplier may subcontract with a pharmacy, physician, provider of services, or another supplier to meet CMS requirements. The home infusion therapy supplier is responsible for negotiating appropriate contract terms in order to only assume responsibility for services related to home infusion therapy.

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/Home-Infusion-Therapy/Overview.html