NHIA 2026: Monday, April 20 Recap

Monday morning kicked off with a high-octane networking breakfast before the General Session which featured a panel of legislative and regulatory experts covering the latest policy developments affecting the home infusion industry. Panelists provided an update on home infusion legislation and reviewed efforts to reign in pharmacy benefit manager (PBM) practices, as well as the implications of new CMS models, including IPAY, GLOBE, and GUARD.

“Having 8 bipartisan members of Congress supporting home infusion is a milestone,” noted Shea McCarthy, NHIA’s Director of Legislative Affairs, referring to the reaction to NHIA President and CEO Connie Sullivan’s testimony before members of the House Energy and Commerce Committee. “However, there isn’t exactly an atmosphere of bipartisanship on Capitol Hill right now.” McCarthy noted that he was as optimistic as he’s ever been about Congress passing the Preserving Patient Access to Home Infusion Act, but it’s likely to happen as part of a larger end-of-the-year package. “We are continuing to do the background work—educating, building allies—to prepare behind the scenes for that opportunity,” he explained. Other important hurdles include obtaining a Congressional Budget Office score—preferably one that indicates savings vs adding costs—and having the bill marked up in committee.

Bill Noyes, NHIA’s Senior VP of Reimbursement Policy, pointed out that how CMS implements the recently passed Joe Fiandra Access to Home Infusion Act (H.R. 4993) will make a difference to providers and possibly to NHIA’s legislative goals. “It could be that a very narrow list of drugs are covered under under Fiandra,” he explained. “That may create some urgency around the need for a functional benefit that promotes wider access.”

PBM reform could bring opportunities for pharmacies, according to Jason Slotnik, JD, MPH, Partner at Health Policy Strategies. While different constituencies have been calling for PBM reform for years, 3 recent developments show that Congress and the Administration are applying pressure on the organizations: the settlement between Express Scripts and the Federal Trade Commission, the Department of Labor’s new proposed rule that would bring transparency to employer contracts under ERISA, and legislation that transitions to a fee-based business model rather the current model based on drug costs.

“I believe that transparency is step 1 in a multi-step process,” explained Soumi Saha, PharmD, JD. “But, if you look at what these public companies are reporting to their shareholders, don’t expect much to change.” Another tool that the government could use is to break up vertical integration in the industry where health insurers own PBMs and pharmacies. “The FTC is looking at that,” she noted.

In other efforts to reduce drug prices, Saha noted that the Trump Administration is very interested in setting an international benchmark, something it pursued in its first term. In addition to making individual deals with pharmaceutical manufactures to lower prices in exchange for investments in U.S. manufacturing and tariff protections, HHS has proposed 2 new pricing models: GLOBE and GUARD. Slotnick explained that there are likely to be numerous legal challenges from manufacturers once those models are finalized.

Noyes noted that the Medicare drug negotiation program IPAY, which to date has only affected Part D drugs, will apply to Part B in 2028. “So far, only 1 drug from our space has been included, but starting in 2028, it will apply to more drugs used by home infusion providers.” That could present challenges for organizations that will have to manage the 21-day float between the time of payment to the time they receive the manufacturer refund. “This will be especially difficult with high-dollar drugs,” he observed

Honoring Achievement and Innovation
We were also proud to honor Melissa Leone, RN, BSN, FNHIA as this year’s Gene Graves Lifetime Achievement Award Recipient for her 35+ year career focused on developing operational practices that enabled consistently safe care for patients while mentoring and developing the clinical leaders of the future. “I fell in love with home infusion for the impact we have on these patients’ lives!” she said, noting that the industry got to where it is showing up each day, and executing on the work as well as we could, while continuing to learn. So, don’t be afraid to show up even when you do not think you have anything to offer – you may be very surprised!”

We also honored a standout for industry innovation with the NHIA Innovation Award, which highlights the role ground-breaking products and services play in improving home infusion patient care and/or advancing operations. The 2026 Innovation Award recipient was Madolin. Mandolin replaces fragmented EMR workflows with AI agents that execute the end-to-end lifecycle, including intake, benefits, prior authorizations, and revenue cycle management to close the gap between referral and first dose.

Sterile Compounding Clinic
The Sterile Compounding Clinic lab kicked off today as participants got hands-on training in a simulated clean room environment in an exclusive area in the NHIA Expo Hall. Participants alternate between this optional lab time and dedicated education by leading experts in the area.

Roundtable Discussions
NHIA’s popular Roundtable Discussions expanded into a larger ballroom to accommodate the more than 600 participants rotating between tables 4 times every 25-minutes while choosing between 40 unique and engaging topics led by an expert moderator. Every table was packed and the conversations were incredibly productive and informative. We heard great feedback about the knowledge sharing and connections enabled by this unique conference feature.

Education Highlights
In a variety of session types throughout the afternoon, we learned and exchanged the latest ideas across 3 education tracks, from nursing to reimbursement. 

In “Home Infusion: Innovating Care Models at Home,” Cassandra Redmond, PharmD, Katherine Major, MSN, RN, CHPN, and Sarah Johnson, MBA explained how Penn Medicine applied the principals of home infusion within their health system to innovate care models that shift patients to the home site of care for multiple therapies, including IV. By shifting care to the most appropriate setting, the organization was able to reduce referral friction, ingrate with hospital operations, improve patient flow, and create sustainable growth capacity. The resulting programs—advanced home health, same-day access clinic, ID shuttle program, and pharmacy-based infusion chairs—reduced inpatient stays, increased hospital capacity and, in many cases, reduced wait time before start of therapy for patients. “Home infusion is a scalable and adaptable care model,” concluded Redmond. “Our success with these newer models depends on our interdisciplinary collaboration and focus on patient-centered care.”

Health care worker violence is addressed in most acute care facilities, but only recently has the focus shifted to care that’s delivered in the community. In 2022, Johns Hopkins Care at Home began listening to home care workers to better understand field staff needs, explained Ali Bryo, Donald Roullier, and Rama Abou-Seif in “Workforce Safety: Building an Industry Leading Model.” The following year, the organization hired a director of public safety and established a multidisciplinary employee safety program that included a threat assessment team to evaluate risks and incidents, updated training incorporating de-escalation techniques, and safety committees. The organization also used innovative technologies such as personal safety devices featuring GPS, alarms and virtual escort services which improved safety and boosted confidence. Employee safety surveys show increased feelings of safety on the job and preparedness before a visit.

NHIA is interested in the differences in nursing effort and workflow across treatment types. In “Understanding Nursing Workload in Infusion Therapy: A Multi-Center Time Study,” Jennifer Charron, RN, MSN, MBA shared the preliminary results from a multi-center nursing time study that quantifies nursing workload across 2 therapy categories—anti-infectives and monoclonal antibodies—capturing the full scope of direct and indirect care activities. A larger percentage of nursing tasks was invested in preparing for patients (Visit 0) in the anti-infective category than monoclonals (22% vs 5%). However, the tasks associated with providing monoclonals shifted across visits with the highest concentration in Visit 1. Key domains evaluated in the study include direct patient care, care coordination, patient education, infusion-related time, and vascular access management.

Elsewhere Around NHIA
In the exhibit hall, we kicked off sessions in the Learning Lab that provides dynamic education in the heart of the NHIA Expo, new Exhibitor Exchanges, and the poster abstracts were on display.

We closed the night with a fundraising event recognizing and supporting the great work of the National Home Infusion Foundation with live music and great people.