Provisions in a new law that came into effect Oct. 1 will allow families affected by hemophilia and other bleeding disorders who are on Medicare to have better access to skilled nursing facilities (SNFs), National Hemophilia Foundation (NHF) announced.
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.
Prior to its approval as part of the 2021 federal finance 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 facilities to provide treatment themselves or to partner with them. a third, 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 SNFs will receive from Medicare includes the costs associated with nursing care, therapy components, medications, necessary supplies, and any necessary equipment, in addition to room, board, and administration costs.
âWith the passage of the law on access to the SNF for hemophilia, the SNF will be adequately reimbursed for expensive treatments needed by 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 SNSF has had in accepting beneficiaries with bleeding disorders, âthe foundation said on a report. 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 [emailÂ protected]