Page 301 - Medicare Benefit Policy Manual

Comprehensive patient assessment is imperative when providing home infusion therapy.
The home infusion therapy supplier may evaluate patient history, current physical and
mental status, lab reports, cognitive and psychosocial status, family/care-partner support,
prescribed treatment, concurrent oral prescriptions, and over-the-counter medications.
For patients receiving potentially life-long, continuous intravenous infusion therapy,
home infusion therapy suppliers can provide extensive support and education and address
necessary lifestyle changes and realistic expectations of life with an ambulatory pump.

320.6.2 - Remote Monitoring and Monitoring Services
(Rev. 10547, Issued: 12-31-20, Effective: 01-01-21, Implementation: 01-04-21)

Qualified home infusion therapy suppliers are required to ensure the safe and effective
provision and administration of home infusion therapy on a 7-day-a-week, 24-hour-a-day
basis. Monitoring the patient receiving infusion therapy in their home is an important
standard of practice that is an integral part of providing medical care to patients in their
home. The expectation is that home infusion therapy suppliers would provide ongoing
patient monitoring and continual reassessment of the patient to evaluate response to
treatment, drug complications, adverse reactions, and patient compliance.

The plan of care would indicate the need for routine monitoring and specify the interval
for evaluation and documentation of patient-reported response to therapy, any adverse
effects or infusion complications, verify pump rate, obtain blood work, and obtain any
necessary vital signs. Direct communication and coordination with the patient,
caregivers, and clinicians regarding any change in the patient’s condition is on-going so
that any adjustment to treatment is made as needed and in a timely fashion. This can be
done remotely or directly during in-home patient visits at specified intervals.

Remote monitoring may be performed through telephone or other electronic
communication, based on the plan of care and the patient’s preference of communication.
Remote monitoring may include the use of a telecommunications system through which
patients are monitored by electronic submission of self-obtained vital signs, such as
weight, blood pressure, and heart rate. The patient must be instructed on obtaining vital
signs and on self-monitoring equipment use. An off-site monitoring service may also be
utilized to communicate any abnormal results to the clinician for adjustments to the plan
of care as needed.

Qualified home infusion therapy suppliers may use all available remote monitoring
methods that are safe and appropriate for their patients and clinicians and as specified in
the plan of care as long as adequate security and privacy protections are utilized.

320.7 - Home Infusion Therapy Drugs
(Rev. 10547, Issued: 12-31-20, Effective: 01-01-21, Implementation: 01-04-21)