HR 8528
PI Post Acute Access Act
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Sign in to take action- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Bill overview
This bill aims to improve access to care for individuals with primary immune deficiency diseases who receive treatment in skilled nursing facilities. It modifies Medicare regulations to allow separate payment for intravenous immune globulin (IVIG) administered to these patients. Specifically, it expands the list of covered IVIG HCPCS codes and ensures that skilled nursing facilities are reimbursed for the related items and services. This change is intended to support better treatment outcomes for those with these rare genetic disorders.
Key provisions
- Expands Medicare coverage to include separate payment for intravenous immune globulin (IVIG) administered to patients with primary immune deficiency diseases.
- Adds specific HCPCS codes (J1561, J1569, J1576, J1568, J1459, J1554, J1557, J1566, and subsequent modifications) to the list of covered IVIG.
- Ensures skilled nursing facilities are reimbursed for items and services related to the furnishing of IVIG.
Who is affected
- Individuals with primary immune deficiency diseases
- Skilled nursing facilities
- Medicare beneficiaries
- Healthcare providers furnishing IVIG
Notable changes
- Changes Medicare payment policies to specifically cover IVIG administered in skilled nursing facilities.
- Expands the list of covered IVIG HCPCS codes.
Sponsors
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Primary sponsor
Cosponsors
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119th CONGRESS — 2d Session
H. R. 8528
IN THE HOUSE OF REPRESENTATIVES
A BILL
To amend title XVIII of the Social Security Act to improve access to skilled nursing facilities for primary immunodeficiency patients.
This Act may be cited as the PI Post Acute Access Act
.
Section 1888(e)(2)(A)(iii) of the Social Security Act (42 U.S.C. 1395yy(e)(2)(A)(iii)) is amended by adding at the end the following new subclause:
The amendment made by subsection (a) shall apply to items and services furnished on or after October 1, 2026.