(3) For purposes of this subsection: (A) The term “applicable provider” means— (i) a physician; (ii) a nurse practitioner; and (iii) a physician assistant. (B) The term “home” means a place of residence used as the home of an individual (as defined for purposes of subsection (n)). (C) The term “home infusion drug” means a parenteral drug or biological administered intravenously, or subcutaneously for an administration period of 15 minutes or more, in the home of an individual through a pump that is an item of durable medical equipment (as defined in subsection (n)). Such term does not include the following: (i) Insulin pump systems. (ii) A self-administered drug or biological on a self-administered drug exclusion list. Clause (ii) shall not apply to a self-administered drug or biological on a self-administered drug exclusion list if such drug or biological was included as a transitional home infusion drug under subparagraph (A)(iii) of section 1395m(u)(7) of this title and was identified by a HCPCS code described in subparagraph (C)(ii) of such section. (D) (i) The term “qualified home infusion therapy supplier” means a pharmacy, physician, or other provider of services or supplier licensed by the State in which the pharmacy, physician, or provider or services or supplier furnishes items or services and that— (I) furnishes infusion therapy to individuals with acute or chronic conditions requiring administration of home infusion drugs; (II) ensures the safe and effective provision and administration of home infusion therapy on a 7-day-a-week, 24-hour-a-day basis; (III) is accredited by an organization designated by the Secretary pursuant to section 1395m(u)(5) of this title ; and (IV) meets such other requirements as the Secretary determines appropriate, taking into account the standards of care for home infusion therapy established by Medicare Advantage plans under part C and in the private sector. (ii) A qualified home infusion therapy supplier may subcontract with a pharmacy, physician, provider of services, or supplier to meet the requirements of this subparagraph.


42 USC § 1395x(iii)(3)

Scoping language

For purposes of this subsection
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