Medicare Home Infusion Therapy Supplier Accreditation

Medicare Home Infusion Therapy Supplier Accreditation

Under Medicare’s home infusion therapy benefit authorized under the 21st Century Cures Act, home infusion therapy suppliers must be accredited by a CMS-approved accreditation organization, such as URAC.

As patients move toward receiving convenient care in their own homes, the demand for home infusion therapy has grown. Congress adopted the 21st Century Cures in 2016 which required the U.S. Department of Health and Human Services (HHS) to create a bundled payment for those providers supplying home infusion therapy services to Medicare beneficiaries. Included in this legislation was a requirement that Home Infusion Therapy Suppliers, including pharmacies, be accredited in order to receive reimbursement.

CMS has awarded URAC with initial deeming authority of Home Infusion Therapy Suppliers for a four-year term through March 27, 2024.

URAC’s Medicare Home Infusion Therapy Supplier Accreditation is designed to not only conform to CMS’s requirements but establishes standards based on industry best practices.

URAC’s Medicare Home Infusion Therapy Supplier Accreditation standards cover practice management, consumer safety, complete care services, and practice standards, guidelines, and protocols. This program applies only to infusion therapy funded by Medicare and provided in the patient’s home. URAC’s Infusion Pharmacy Accreditation addresses infusion therapy for all other payers and sites of administration. The standards for these two programs are the same, and URAC anticipates that many pharmacies will pursue both accreditations simultaneously. Please click here to learn more.

The URAC-accredited Medicare home infusion therapy supplier:

  • Handles specialized, complex pharmaceutical and/or nutritional products by managing infusion therapy plans.
  • Provides for clinical assessment and ongoing monitoring of patients in their homes or other alternative ambulatory care sites.
  • Maintains ongoing monitoring and important consumer safety protections associated with infusible therapies consistent with CMS regulations and industry best practices.
  • Encourages coordinated patient care via a multidisciplinary team, with comprehensive assessments and care planning.
  • Provides patient & caregiver education, and reports on adverse events.
  • Has policies and procedures in place to ensure consumers have access to appropriate medications and/or nutritional products.
  • And more.

Download our Medicare Home Infusion Therapy Supplier Standards-at-a-Glance.

Who may apply

Pharmacy-based home infusion suppliers in good standing located in the United States billing or seeking to bill Medicare for home infusion therapy services. Those that have already achieved URAC Specialty Pharmacy Accreditation or are seeking URAC Specialty Pharmacy Accreditation are encouraged to apply.

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