[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1845 Introduced in House (IH)]
112th CONGRESS
1st Session
H. R. 1845
To provide for a study on issues relating to access to intravenous
immune globulin (IVIG) for Medicare beneficiaries in all care settings
and a demonstration project to examine the benefits of providing
coverage and payment for items and services necessary to administer
IVIG in the home.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 11, 2011
Mr. Brady of Texas (for himself, Ms. Matsui, Mr. Burgess, Mr. Sarbanes,
Mr. Paul, Mr. Van Hollen, Mr. Tiberi, Mr. Ruppersberger, Mrs.
Blackburn, Mr. Schiff, Ms. Jenkins, Mr. Kind, Ms. Fudge, Ms.
Richardson, and Mr. Rush) introduced the following bill; which was
referred to the Committee on Ways and Means, and in addition to the
Committee on Energy and Commerce, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To provide for a study on issues relating to access to intravenous
immune globulin (IVIG) for Medicare beneficiaries in all care settings
and a demonstration project to examine the benefits of providing
coverage and payment for items and services necessary to administer
IVIG in the home.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicare IVIG Access Act''.
SEC. 2. MEDICARE PATIENT IVIG ACCESS DEMONSTRATION PROJECT.
(a) Establishment.--The Secretary shall establish and implement a
demonstration project under title XVIII of the Social Security Act to
evaluate the benefits of providing payment for items and services
needed for the administration, within the homes of Medicare
beneficiaries, of intravenous immune globin for the treatment of
primary immune deficiency diseases.
(b) Duration and Scope.--
(1) Duration.--Beginning not later than 6 months after the
date of enactment of this Act, the Secretary shall conduct the
demonstration project for a period of 3 years.
(2) Scope.--The Secretary shall enroll not greater than
4,000 Medicare beneficiaries who have been diagnosed with
primary immunodeficiency disease for participation in the
demonstration project. A Medicare beneficiary may participate
in the demonstration project on a voluntary basis and may
terminate participation at any time.
(c) Reimbursement.--The Secretary shall establish an hourly rate
for payment for items and services needed for the administration of
intravenous immune globin based on the low-utilization payment
adjustment under the prospective payment system for home health
services established under section 1895 of the Social Security Act (42
U.S.C. 1395fff).
(d) Study and Report to Congress.--
(1) Interim evaluation and report.--Not later than 24
months after the date of enactment of this Act, the Secretary
shall submit to Congress a report that contains the following:
(A) An interim evaluation of the impact of the
demonstration project on access for Medicare
beneficiaries to items and services needed for the
administration of intravenous immune globin within the
home.
(B) An analysis of the appropriateness of
implementing a new methodology for payment for
intravenous immune globulins in all care settings under
part B of title XVIII of the Social Security Act (42
U.S.C. 1395k et seq.).
(C) An analysis of the feasability of reducing the
lag time with respect to data used to determine the
average sales price under section 1847A of the Social
Security Act (42 U.S.C. 1395w-3a).
(D) An update to the report entitled ``Analysis of
Supply, Distribution, Demand, and Access Issues
Associated with Immune Globulin Intravenous (IGIV)'',
issued in February 2007 by the Office of the Assistant
Secretary for Planning and Evaluation of the Department
of Health and Human Services.
(2) Final evaluation and report.--Not later than July 1,
2015, the Secretary shall submit to Congress a report that
contains a final evaluation of the impact of the demonstration
project on access for Medicare beneficiaries to items and
services needed for the administration of intravenous immune
globin within the home.
(e) Offset.--
(1) In general.--Section 1861(n) of the Social Security Act
(42 U.S.C. 1395x(n)) is amended by adding at the end the
following: ``Such term includes disposable drug delivery
systems, including elastomeric infusion pumps, for the
treatment of colorectal cancer.''.
(2) Effective date.--The amendment made by paragraph (1)
shall apply to items furnished on or after the date of
enactment of this Act.
(f) Definitions.--In this Act:
(1) Demonstration project.--The term ``demonstration
project'' means the demonstration project conducted under this
Act.
(2) Medicare beneficiary.--The term ``Medicare
beneficiary'' means an individual who is entitled to, or
enrolled for, benefits under part A of title XVIII of the
Social Security Act or enrolled for benefits under part B of
such title.
(3) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
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