Why doesn't medicare pay for IV antibiotics?

  1. Why doesn't medicare pay for IV antibiotics?

    I hate the idea of sending someone with medicare as only insurance to a skilled nursing facilty (SNF) for the duration of the IV antibiotics. Doesn't Medicare see that this is a huge waste of resources by sending someone to a SNF if they don't have physical therapy needs, just a PICC or a midline and the need for IV antibiotics?
    This is a lose-lose situation, patient has to wait for bed availability and then risks getting an infection while at the snf. It can't be about money or they would open their eyes and see how wasteful it is.

    Does anyone know of a way to get medicare to cover it if there is no other secondary insurance?

    Does AARP coverage cover IV antibiotics if it is a secondary. Also if someone is a VA player ,and greater than 65 is it possible the VA would cover home IV antibiotics.

    Are there any free standing IV rooms, as part of a hospital, that are willing to put an IV in a confused patient daily for a week or two while the IV runs in as long as there is a caregiver at their side? I would appreciate any names of IV centers in the states of New Jersey, Pennsylvania or Delaware.
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    About edgwow

    Joined: Aug '06; Posts: 168; Likes: 40
    Specialty: Case Managemnt, Utilization Review


  3. by   Wren
    I can't answer your question about WHY Medicare won't pay for home IV antibiotics but I can tell you one solution I use when possible. If a patient can get to an infusion center 3x a week, then they may be able to get their abx in an infusion pump for continuous infusion. Depends on the med and dosing schedule of course but we have an infectious disease doc who rounds in our hospital and he has an infusion suite in his office that does this for us. Medicare will apparently pay for the pt to get IV ABX in the provider's office up to 3x a week. This only works if your pt isn't home bound and has transportation to get to the office. They need to to have a PICC or something similar. Check with the infectious disease docs in your area.