I 

118TH CONGRESS 

2D SESSION H. R. 9778 

To amend title XVIII of the Social Security Act to include penicillin allergy 

verification and evaluation as part of the initial preventive physical examination under the Medicare program. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 24, 2024 

Mr. BUCSHON (for himself, Mr. BERA, Mr. GRIFFITH, Mr. PETERS, Mr. MURPHY, Ms. SCHRIER, Mr. KELLY of Pennsylvania, Ms. DELBENE, Mrs. 

MILLER-MEEKS, and Ms. UNDERWOOD) introduced the following bill; 

which was referred to the Committee on Energy and Commerce, and in 

addition to the Committee on Ways and Means, 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 amend title XVIII of the Social Security Act to include 

penicillin allergy verification and evaluation as part of 

the initial preventive physical examination under the 

Medicare program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Penicillin Allergy 

5 Verification and Evaluation Act’’ or the ‘‘PAVE Act’’. 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
2 

•HR 9778 IH

1 SEC. 2. FINDINGS. 

2 Congress makes the following: 

3 (1) On September 28, 1928, Alexander Flem4 ing, a Scottish bacteriologist, discovered penicillin, 

5 forever changing healthcare by identifying an effec6 tive way to treat a wide range of infections which 

7 opened the doctor for numerous successful medical 

8 treatments. 

9 (2) Millions of patients believe they are allergic 

10 to penicillin, but information cited by the Centers 

11 for Disease Control and Prevention and recent med12 ical journal articles in the Journal of the American 

13 Medical Association and the Journal of Allergy and 

14 Clinical Immunology, shows that more than 90 per15 cent of patients who have a self-reported penicillin 

16 allergy in their electronic medical record can safely 

17 take penicillin after verification testing. 

18 (3) A 2020 medical research review found, peni19 cillin allergy is estimated to affect approximately 10 

20 percent of the population, and 15 percent of hos21 pitalized patients are labeled with a penicillin al22 lergy. 

23 (4) Penicillin allergy label is associated with 

24 poor patient outcomes including increased hospital 

25 length of stay, increased perioperative infections, 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
3 

•HR 9778 IH

1 and overall increased mortality according to the New 

2 England Journal of Medicine. 

3 (5) A 2018 paper in the Journal of Allergy and 

4 Clinical Immunology indicates that penicillin allergy 

5 evaluation by any means has been shown to be a 

6 cost-saving intervention. 

7 (6) Delabeling penicillin allergy is an important 

8 component of antibiotic stewardship and is endorsed 

9 by many professional organizations and public health 

10 bodies, including the American Academy of Allergy, 

11 Asthma & Immunology. 

12 (7) A 2023 study of adults 65 and older with 

13 a penicillin allergy label published in the Annals of 

14 Allergy, Asthma & Immunology found that 97 per15 cent were disproved after verification testing. 

16 SEC. 3. PENICILLIN ALLERGY VERIFICATION AND EVALUA17 TION FOR SENIORS. 

18 (a) INITIAL PREVENTIVE PHYSICAL EXAMINA19 TION.—Section 1861(ww) of the Social Security Act (42 

20 U.S.C. 1395x(ww)) is amended— 

21 (1) In paragraph (1)— 

22 (A) by inserting ‘‘penicillin allergy 

23 verification and evaluation (as defined in para24 graph (5)),’’ after ‘‘(as defined in paragraph 

25 (4)),’’; and 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
4 

•HR 9778 IH

1 (2) in paragraph (2)— 

2 (A) by redesignating subparagraph (O) as 

3 subparagraph (P); and 

4 (B) by inserting after subparagraph (N) 

5 the following new subparagraph: 

6 ‘‘(O) Penicillin allergy verification and 

7 evaluation.’’; and 

8 (3) by adding at the end the following new 

9 paragraph: 

10 ‘‘(5) For purposes of paragraph (1), the term 

11 ‘penicillin allergy verification and evaluation’ 

12 means— 

13 ‘‘(A) identification of individuals reporting 

14 a history of penicillin allergy; 

15 ‘‘(B) consideration of whether the reported 

16 reaction history is consistent with an allergy or 

17 hypersensitivity reaction or can be reevaluated; 

18 ‘‘(C) the provision of information on the 

19 adverse individual and public health impact of 

20 a penicillin allergy label; and 

21 ‘‘(D) a referral to an allergy or immu22 nology specialist, as appropriate.’’. 

23 (b) ANNUAL WELLNESS VISIT.—Section 

24 1861(hhh)(2) of the Social Security Act (42 U.S.C. 

25 1395x(hhh)(2)) is amended— 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
5 

•HR 9778 IH

1 (1) by redesignating subparagraph (I) as sub2 paragraph (J); and 

3 (2) by inserting after subparagraph (H) the fol4 lowing new subparagraph: 

5 ‘‘(I) Penicillin allergy verification and eval6 uation (as defined in subsection (ww)(5)).’’. 

7 (c) RULE OF CONSTRUCTION.—Nothing in the 

8 amendments made by subsection (a) or (b) shall be con9 strued to prohibit separate payment for structured peni10 cillin allergy validation and evaluation services furnished 

11 to an individual on the same day as an initial preventive 

12 physical examination or an annual wellness visit. 

13 (d) EFFECTIVE DATE.—The amendments made by 

14 this section shall apply to examinations and visits fur15 nished on or after January 1, 2025. 

Æ 


kjohnson on DSK7ZCZBW3PROD with $$_JOB