Message from the NICA director
September 2019 Message from the Director

Hello colleagues,

I hope this message finds everyone well and rested after the long holiday weekend.

Downcoding Petition

Last year, we partnered with the National Organization of Rheumatology Managers (NORM) to submit joint comments to UnitedHealthcare (UHC) regarding a change in the Injection and Infusion Services Policy to require that the administrative codes for four complex biologics be “downcoded” or reimbursed as simple therapeutic codes. In addition to the comments, we sent signatures from 129 infusion practices across the country expressing their concern of the further reduction in the reimbursement of biologic drugs.

Unfortunately, Humana is adopting a similar strategy and we need your help! We have written a letter to senior leadership at Humana and would like to have even more representation from infusion providers than we did last year! If you own, operate, or work for an infusion facility, we have created another petition that you can sign to let Humana know you oppose this practice. Sign the petition here.

We are dedicated to conveying the importance of appropriate reimbursements and hope to deter other insurers from implementing these downcoding strategies for the repayment of biologic drugs. Learn more about how downcoding can negatively impact patients’ access to care.

Call for Meeting Topics

We are already hard at work securing speakers for our 2020 meeting, and we need your help! To ensure we are addressing the most pertinent issues in the infusion industry, we’d like to know which topics you’re most interested in! Please take a moment to submit your suggestions for breakout sessions and/or workshops here.

Future Advocacy Efforts

As we anticipate future developments regarding the International Pricing Index (IPI) model and the House and Senate drug pricing packages, it is important we are proactive in collecting examples of how the patient experience, health outcomes, and quality of life are enhanced by access to in-office infusion/injection therapy.

I encourage all of you to join our growing advocacy network and take action when legislation in your state threatens patients’ access to care. We know there are patients in each of your infusion centers who are deeply appreciative of the care they receive. If you know of a patient who might be willing to share their in-office infusion experience, I encourage you to reach out to our communications coordinator, Amy Rios ([email protected]), or share some of the patient stories we’ve already collected.

Thank you for your continued support and belief in NICA’s mission as we prepare to tenaciously advocate for patients’ access to economical, compassionate, and accessible sites for infusion/injection care.

Thank you for your time,

Brian Nyquist, MPH

Executive Director, National Infusion Center Association

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