New law helps open specialized nursing facilities for hemophilia patients

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The provisions of a new law that came into force on October 1 make it easier for families affected by hemophilia and other bleeding disorders who benefit from Medicare to access qualified nursing facilities (SNF ), announced the National Hemophilia Foundation (NHF).

This law, known as the Hemophilia SNF Access Act, is expected to rectify the challenges families face in obtaining treatment, the NHF said in a press release.

Getting this law passed was a top priority for the foundation throughout 2020, which saw the law as essential in helping to ease the financial burden of hemophilia and other inherited bleeding disorders on patients and their families.

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Prior to its approval as part of the 2021 federal budget bill, few SNFs were willing to admit patients with inherited bleeding disorders because Medicare reimbursement did not adequately cover the cost of factor therapies. coagulation that they needed.

Under this law, NFCs can separately bill for hemophilia and other inherited bleeding disorders treatments given to people covered by Medicare, allowing institutions to provide the treatment themselves or to pay for them. partner with a third party, such as a specialty pharmacy.

Medicare will also be required to adequately reimburse facilities that treat patients with inherited bleeding disorders, allowing stays of up to 100 days (short stays) provided the patient meets certain criteria, including a hospital stay of at least three days or 72 hours. According to the NHF, this benefit is likely to be useful after surgery or a prolonged hospital stay.

The pooled payment that NFCs will receive from Medicare includes the costs associated with nursing care, therapeutic components, medications, necessary supplies, and any necessary equipment, in addition to room, board, and administration costs.

“With the passage of the law on access to the SNF for hemophilia, the SNF will be adequately reimbursed for expensive treatments needed for patients with bleeding disorders, thus removing a major barrier to care for the SNF. The NHF believes that this should be enough to allay the concerns that the FNS have had to accept beneficiaries with bleeding disorders, ”the foundation said in a fact sheet listing the provisions of the law.

In terms of treatment, the law covers a wide range of therapies used by people with inherited bleeding disorders, in addition to clotting factors.

Future approved treatments are expected to be added to covered therapies, the NHF noted. The secretary of the US Department of Health and Human Services has the authority to expand the list of treatments that can be billed separately, and the foundation is also working to recommend additional treatments.

As more information becomes available, the NHF intends to continually update its fact sheet.

People with questions or needing help getting someone into an SNF can write to Marla Feinstein at [email protected]


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