Need advice for a friend

[scrabblern]

Hi,

I am a neonatal nurse and this is really out of my scope so I'm asking for help. My friend's husband just turned 65 and he's been disabled with neuro degenerative disease for many years. He is on IV abx now and according to his wife they had to go to ER 3 times for the PIV. She refused PICC on his behalf. She said that medicare would not cover for an RN to come in and restart an IV and that they have to go to ER. This makes no sense to me. I would like how is that possible? I am not sure thst she's aware of all the resources she has.

Thanks!

[scrabblern, RN]

This is in Oregon. I looked at visiting nurse association website and saw that they don't have a branch in Oregon. Made me wonder.

[KelRN215, BSN, RN]

Medicare doesn't pay for home infusion. I have worked for a Medicare/Medicaid certified home health agency and now for home infusion. Our field nurses in home infusion do start/manage peripheral IVs but neither Medicare nor Medicaid will pay for our nursing services, the patients need to have a separate agency for nursing. And most nursing agencies don't do peripheral IVs. I know we didn't touch anything peripheral when I was in home health, we would only take patients with some sort of central access.

[Libby1987]

I'm in California but qualifying hospital stays are not required for Medicare reimbursed home health services.

Medicare pays for SN visits for PICC care but it doesn't cover the drugs or fluids in the home setting, only out patient or inpatient. For patients that pay OOP for their drug, which is uncommon due to being so cost prohibitive for most, we can and are reimbursed by Medicare for weekly and prn SN visits for PICC mgmt and lab draws.

[JustMeRN]

I don't manage iv's, but I do believe the agency does for short term (ie patient only needs a couple more doses when home). However, if I recall correctly Medicare will not pay for the medication as outpatient, so that is more of a hang up for Medicare iv clients. The cost of the infusion is often times the prohibitive factor with Medicare patients, and they are required to go to an outpatient facility to get their infusions, even if they have a pic line and are active with a home care agency. Stupid system.