You must be presented a choice of where to receive your IV therapy, whether at home or an infusion therapy center. You must also be given a choice of infusion providers. All providers, including hospitals and clinics, are required to provide The Right to Freedom of Choice. Make sure your medical provider (i.e. physician, nurse, social worker or discharge planner) gives you a choice. Tell them you would like to receive home infusion with your provider of choice.
Patients' Right to Freedom of Choice:
All providers are required to provide the right to freedom of choice of providers to patients and settings in which to receive services and to abide by their choices. There are a number of sources of this right as follows:
1) All patients have a common law right, based upon court decisions, to control the care provided to them, including who renders it. Thus, when patients, regardless of payor source or type of care, voluntarily express preferences for providers, their choices must be honored.
2) Federal statutes of the Medicare and Medicaid Programs guarantee Medicare beneficiaries and Medicaid recipients the right to freedom of choice of providers. When Medicare and Medicaid patients voluntarily express a preference for infusion companies, their choices must be honored.
3) Conditions of Participation (CoP's) of the Medicare Program require hospitals to honor patients' right to freedom of choice. They also include enforcement mechanisms for these requirements. Hospitals are subject to survey by state survey agencies and may lose their certification for participation in both the Medicare and Medicaid Programs if they do not comply with these requirements.
The CoP's in the Code of Federal Regulations {42 CFR Section 482.43 (c) (6) and (7)} state as follows:
"(7) ...The hospital [emphasis added] must not specify or otherwise limit the qualified providers that are available to the patient."
Based upon the above, it is clear that hospitals may not limit providers of home infusion services and specialty pharmacies, including those that provide IV antibiotics, cardiac inotropes, IV therapies for transplant patients, home parenteral nutrition, IV therapies for pain/palliative care, et al.
Likewise, a decision of the U.S. Supreme Court, Olmstead v. LC, makes it clear that services to patients must be provided in the least restrictive setting. Patients may, for example, elect to receive infusion and specialty pharmacy services at home, if clinically appropriate.
