HR 2343
John W. Walsh Alpha-1 Home Infusion Act of 2025
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Bill overview
The John W. Walsh Alpha-1 Home Infusion Act of 2025 aims to expand Medicare coverage for treatment of Alpha-1 Antitrypsin Deficiency Disorder. Specifically, it allows for coverage of at-home augmentation therapy for individuals with emphysema caused by severe hereditary deficiency, provided the treatment is administered by qualified home infusion therapy suppliers under the care of a physician, nurse practitioner, or physician assistant. The bill also includes provisions for payment for intravenous administration kits and nursing services associated with this treatment.
Key provisions
- Medicare coverage for augmentation therapy for Alpha-1 Antitrypsin Deficiency Disorder in individuals with emphysema.
- Treatment must be administered by qualified home infusion therapy suppliers.
- Treatment requires care from a physician, nurse practitioner, or physician assistant.
- Establishment of a payment system for intravenous administration kits and nursing services.
- Payment rate of 80% for intravenous administration kits and nursing services, subject to actual charges.
- Specific definitions for key terms, including ‘Alpha-1 Antitrypsin Deficiency Disorder treatment’ and ‘qualified home infusion therapy supplier’.
- Clarification of payment procedures for home infusion therapy suppliers.
- Amendment to exclude intravenous administration kits and nursing services from standard home health services.
Who is affected
- Individuals with Alpha-1 Antitrypsin Deficiency Disorder
- Healthcare providers (physicians, nurse practitioners, physician assistants)
Sponsors
Official sponsors from legislative records.
Primary sponsor
Cosponsors
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119th CONGRESS — 1st Session
H. R. 2343
IN THE HOUSE OF REPRESENTATIVES
A BILL
To amend title XVIII of the Social Security Act to provide for coverage and payment of Alpha-1 Antitrypsin Deficiency Disorder treatment under part B of such title, and for other purposes.
This Act may be cited as the John W. Walsh Alpha-1 Home Infusion Act of 2025
.
Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended—
in subsection (s)(2)—
by striking and
at the end of subparagraph (II);
by inserting and
at the end of subparagraph (JJ); and
by inserting at the end the following new subparagraph:
by adding at the end the following new subsection:
Alpha-1 Antitrypsin Deficiency Disorder treatmentmeans augmentation therapy (as defined in paragraph (2)(C)) furnished by qualified home infusion therapy suppliers (as defined in paragraph (2)(D)) which are furnished in the individual’s home (as defined in paragraph (2)(B)) to an individual—
who is under the care of an applicable provider;
who is enrolled under both parts A and B of this title, and is not enrolled in an MA plan under part C of such title; and
For purposes of this subsection:
The term applicable provider
means—
a physician;
a nurse practitioner; and
a physician assistant.
The term home
means a place of residence used as the home of an individual (as defined for purposes of subsection (n)).
augmentation therapymeans an Alpha-1 Proteinase Inhibitor indicated for chronic augmentation and maintenance therapy in adults with clinical evidence of emphysema due to severe hereditary deficiency of Alpha-1 Antitrypsin.
The term qualified home infusion therapy supplier
has the meaning given such term in subsection (iii)(3)(D)(i).
Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by adding at the end the following new subsection:
Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended—
by striking and
before (HH)
; and
by inserting before the semicolon at the end the following: , and (II) with respect to intravenous administration kits and nursing services described in section 1834(aa) for Alpha-1 Antitrypsin Disorder treatment (as defined in subsection (nnn)(1)), the amount paid for such kits and services shall be an amount equal to 80 percent of the lesser of the actual charge for the services or the amount determined under section 1834(aa)
.
The first sentence of section 1842(b)(6) of the Social Security Act (42 U.S.C. 1395u(b)(6)) is amended—
by striking and
before (J)
; and
by inserting before the period at the end the following: , and (K) in the case of intravenous administration kits and nursing services described in section 1834(aa), payment shall be made to the qualified home infusion therapy supplier (as defined in section 1861(nnn)(2)(D))
.
Section 1861(m) of the Social Security Act (42 U.S.C. 1395x(m)) is amended, in the first sentence, by inserting the following before the period at the end: and intravenous administration kits and nursing services described in section 1834(aa) for Alpha-1 Antitrypsin Deficiency Disorder treatment (as defined in subsection (nnn)(1))
.
The amendments made by this section shall apply to items and services furnished on or after January 1, 2027.