Beginning on Sept. 1, Harvard Pilgrim will be offering a voluntary home infusion program for infliximab and immunoglobulin (IVIG) treatment in conjunction with Coram CVS Specialty Infusion Services. If any of your Harvard Pilgrim members are administered these medications in an outpatient setting, you and the patient may receive a letter or phone call from a CVS/Coram clinical care team member to discuss the possibility of having the patient receive home infusion services.
Since many patients prefer receiving infusion services in the comfort of their home, this voluntary program offers our members added convenience, and is cost-effective.
The medical drugs included in this voluntary program are:
- Infliximab — Remicade, Inflectra, Renflexis
- IVIG — Bivigam, Carimune, Flebogamma, Gammagard Liquid, Gammagard S/D, Gammaked, Gammaplex, Gamunex-C, Octagam, and Privigen.
How the program works
CVS/Coram will contact patients receiving these medications to determine if they are interested in home infusion services. If so, the CVS/Coram clinical staff will contact the physician to review the member’s case and ensure that the patient is an appropriate candidate for in-home service. If the provider agrees, Coram will collaborate with the provider on the transition to home infusion, working together to obtain the necessary orders and making the therapy arrangements with the patient.
At the start of the program, a CVS/Coram care team member will perform a detailed initial clinical assessment for the medication and an introduction to Coram with the patient. The same nurse will be assigned for each visit with the patient; this consistency helps ensure that subtle changes in patient response to treatment can be identified over time. After each visit, Coram will provide the patient’s physician with a clinical report via fax or telephone, based on the physician’s preference.
Other home infusion providers may be used
While we are working with CVS/Coram on outreach for this voluntary program, you may choose to use another home infusion provider. If you currently work with a home infusion provider for these or other medications, you can continue to do so. If you want to get a patient started with home infusion but would prefer to use a vendor other than Coram, contact Harvard Pilgrim’s Provider Service Center at 800-708-4414.
Prior authorization needed
Information about the program will be included in authorization determination letters after prior authorization has been granted, and phone calls to the member and physician will occur after that. We will also send letters about this home infusion program to providers with patients who were authorized to receive these intravenous medications earlier in 2018, as well as to these patients.
As a reminder, the medical drugs included in this program require prior authorization from CVS Health—Novologix. For details on the prior authorization program for medical drugs, including criteria and prior authorization request forms, please refer to the Medical Drug Prior Authorization page on our provider website.
