ADVOCACY UPDATES FROM IIS AND NICA: Keeping Members Informed
At IIS, we are committed to delivering meaningful value to our members across every aspect of the infusion landscape—including staying connected to the advocacy efforts and policy developments shaping our industry. Through our strong partnership with the National Infusion Center Association (NICA), we’re able to keep members informed on the legislative and regulatory issues impacting infusion providers and patient access nationwide.
As rising healthcare costs continue to strain both patients and providers, decisions made in Washington, DC will shape the future of infusion care. The National Infusion Center Association (NICA) is at the forefront, amplifying provider voices and advancing policies that strengthen infusion centers across the country.
Medicare Negotiations & The Push for PACTA
2026 has marked a turning point in federal drug pricing policy, with significant implications for infusion providers and the patients they serve. For the first time, CMS has selected Part B drugs for the Medicare Drug Price Negotiation Program (MDPNP), with negotiated prices set to take effect in 2028.
As currently designed, the program bases the percentage-based add-on payment (which helps cover overhead, administrative, and staff costs) on the lower negotiated prices, raising concerns that providers may receive less revenue and that patients could have a harder time accessing treatment.
In response, NICA encouraged infusion providers to speak directly about real-world impacts on patient outcomes and access to care at CMS’s Town Hall to discuss MDPNP. At the same time, NICA is advancing a legislative strategy on Capitol Hill to support the Protecting Patient Access to Cancer and Complex Therapies Act (PACTA), a bill aimed at safeguarding providers from the unintended consequences of the MDPNP and protecting provider reimbursement.
PBM Reform, Rebates, and the Global Pricing Outlook
Beyond MDPNP, broader drug pricing reforms are also reshaping the landscape. Pharmacy benefit manager (PBM) reform has gained significant momentum. In February, President Trump signed legislation into law separating PBM compensation from drug list prices in Medicare Part D, requiring manufacturer rebates to be passed through to employer plans, and banning “spread pricing” (a practice where PBMs charge health plans more for medication than they pay the pharmacy, pocketing the difference as profit) in Medicaid.
NICA supported these efforts by submitting a letter to congressional leadership and mobilizing members to advocate for the bill. At the same time, scrutiny of PBMs has intensified, including a Federal Trade Commission settlement with Express Scripts mandating changes to pricing practices. With PBMs controlling a large share of drug claims, these developments carry important implications for patient access, affordability, and the infusion ecosystem.
Most Favored Nation (MFN) pricing remains a priority for the administration and a concern for infusion providers due to its potential impact on access and sustainability. As Medicaid MFN agreements advance and CMS’s proposed GLOBE model seeks to base Medicare Part B payments on drug prices in other countries, NICA has raised concerns about how these changes could affect providers’ ability to continue offering certain treatments. Through formal comments to CMS, NICA has urged consideration of real-world implications for both providers and patients.
Together, these developments underscore the growing importance of active advocacy to ensure evolving drug pricing policies support, not undermine, infusion care. NICA remains committed to elevating the provider voice throughout the policymaking process.
Maintaining a strong pulse on advocacy and industry change is one of the many ways IIS supports and strengthens our member network. Our partnership with NICA helps ensure members have access to timely insights, trusted representation, and a broader voice in the evolving healthcare environment.
Questions or topics you’d like to learn more about in future newsletters? Send us a note here: announcements@infinityinfusion.com.