NHIA Publishes Draft Comments to CMS on Proposed Changes to Immune Globulin HCPCS
NHIA strongly opposes CMS’s proposed HCPCS coding and billing unit changes for immune globulin products, arguing that the changes would create significant administrative, operational, reimbursement, and patient care challenges without providing meaningful clinical or financial benefit. The comments emphasize that the proposal could disrupt patient access to life-sustaining therapies, increase claim denials and compliance risks, and require extensive system updates across providers, payors, manufacturers, and pharmacies. NHIA recommends that CMS withdraw the proposal entirely or, if changes proceed, standardize billing units across products, delay implementation by at least 18 months, provide transparent rationale for the changes, and allow overlap periods and automatic prior authorization crosswalks to minimize disruption. Infusion organizations are encouraged to submit individual comments to CMS hcpcs@cms.hhs.gov. View the draft comments.
Watch the recording for last week’s Talk Infusion virtual discussion to learn more about the proposed immune globulin HCPCS coding changes.
Your Research Can Shape the Future of Home Infusion
Access up to $10,000 in research funding through the new NHIF Research Grant Program. NHIA provider members are eligible for funding to support projects that examine innovative approaches to clinical practice, identify best practices, or improve quality of home and alternate site infusion care. NHIF encourages research that answers patient-centered questions or improves quality. Learn more.
Submit a letter of inquiry by July 1 to be considered for a 2026 grant.
House Committee Advances Community Pharmacist Services Legislation
The House Ways and Means Committee held a mark-up to consider 8 bipartisan health-related bills, including H.R. 3164 is the “Ensuring Community Access to Pharmacist Services Act,” which will advance to the House for a vote at a later date. The legislation creates a new Medicare-covered pharmacist service category. Covered services include evaluation, testing, and treatment related to COVID-19, Influenza, RSV, strep throat, and other declared public health emergencies. Reimbursement would be tied to the physician fee schedule—generally at 85% of physician payment levels and potentially 100% during declared public health emergencies. Supporters say the bill would improve access to testing and treatment, especially in rural and underserved areas; use community pharmacists to reduce pressure on physician offices and ERs and formalize pharmacist clinical roles that expanded during COVID. Read the legislation.
Texas Med Spa Owner, Physician Charged in Patient Death
A Texas med spa owner and medical supervisor were arrested after allegedly administering an unsafe IV infusion that led to a 2023 death. The defendants face several charges, including felony murder, practicing medicine without a license, and delivery of a dangerous drug. Prosecutors say the patient received an “IV cocktail” containing parenteral nutrition (PN) electrolytes, which are intended to be infused over 12-24 hours, but she reportedly went into cardiac arrest less than 30 minutes after treatment began. An investigation by the Texas Medical Board found that the patient died of cardiac arrest due to the improper administration and in 2024 suspended the license of the physician who oversaw the spa. The spa owner who administered the IV did not have a medical license. The death resulted in “Jenifer’s Law,” signed in Texas in 2025, to strengthen oversight of med spas. Learn more.
OIG Reports on Part D Sponsors and Vertical Integration
The HHS Office of Inspector General (OIG) released a Data Snapshot, “Impacts of Vertical Integration in Medicare Part D on Sponsors’ Drug Costs, Pharmacy Reimbursement, and Enrollee Cost Sharing.” The OIG found that while overall net costs of drugs were similar for vertically integrated Part D sponsors and others, vertically integrated plans offered much lower monthly premiums and substantially higher out-of-pocket costs. The OIG also found that vertically integrated organizations managed prescription drug benefits for 79% of Part D enrollees, and that only 6 vertically integrated Part D sponsors accounted for 82% of Part D spending. Read the report.