112TH CONGRESS 
2D SESSION 
H. R. 1845 
AN ACT 
To provide a demonstration project providing Medicare cov-
erage for in-home administration of intravenous immune 
globulin (IVIG) and to amend title XVIII of the Social 
Security Act with respect to the application of Medicare 
secondary payer rules for certain claims. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare IVIG Access 
and Strengthening Medicare and Repaying Taxpayers Act 
of 2012’’. 
TITLE I—MEDICARE IVIG 
ACCESS 
SEC. 101. MEDICARE PATIENT IVIG ACCESS DEMONSTRA-
TION PROJECT. 
(a) ESTABLISHMENT.—The Secretary shall establish 
and implement a demonstration project under part B of 
title XVIII of the Social Security Act to evaluate the bene-
fits of providing payment for items and services needed 
for the in-home administration of intravenous immune 
globin for the treatment of primary immune deficiency dis-
eases. 
(b) DURATION AND SCOPE.— 
(1) DURATION.—Beginning not later than one 
year 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 
more than 4,000 Medicare beneficiaries who have 
been diagnosed with primary immunodeficiency dis-
ease for participation in the demonstration project. 
A Medicare beneficiary may participate in the dem-
onstration project on a voluntary basis and may ter-
minate participation at any time. 
(c) COVERAGE.—Except as otherwise provided in this 
section, items and services for which payment may be 
made under the demonstration program shall be treated 
and covered under part B of title XVIII of the Social Se-
curity Act in the same manner as similar items and serv-
ices covered under such part. 
(d) PAYMENT.—The Secretary shall establish a per 
visit payment amount for items and services needed for 
the in-home administration of intravenous immune globin 
based on the national per visit low-utilization payment 
amount under the prospective payment system for home 
health services established under section 1895 of the So-
cial Security Act (42 U.S.C. 1395fff). 
(e) WAIVER AUTHORITY.—The Secretary may waive 
such requirements of title XVIII of the Social Security Act 
as may be necessary to carry out the demonstration 
project. 
(f) STUDY AND REPORT TO CONGRESS.— 
(1) INTERIM EVALUATION AND REPORT.—Not 
later than three years after the date of enactment of 
this Act, the Secretary shall submit to Congress a 
report that contains an interim evaluation of the im-
pact of the demonstration project on access for
Medicare beneficiaries to items and services needed 
for the in-home administration of intravenous im-
mune globin. 
(2) FINAL
EVALUATION
AND
REPORT.—Not 
later than one year after the date of completion of 
the demonstration project, the Secretary shall sub-
mit to Congress a report that contains the following: 
(A) A final evaluation of the impact of the 
demonstration project on access for Medicare 
beneficiaries to items and services needed for 
the in-home administration of intravenous im-
mune globin. 
(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 So-
cial Security Act (42 U.S.C. 1395k et seq.). 
(C) 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.
(g) FUNDING.—There shall be made available to the 
Secretary to carry out the demonstration project not more 
than $45,000,000 from the Federal Supplementary Med-
ical Insurance Trust Fund under section 1841 of the So-
cial Security Act (42 U.S.C. 1395t). 
(h) DEFINITIONS.—In this section: 
(1) DEMONSTRATION
PROJECT.—The term 
‘‘demonstration project’’ means the demonstration 
project conducted under this section. 
(2) 
MEDICARE
BENEFICIARY.—The 
term 
‘‘Medicare beneficiary’’ means an individual who is 
enrolled for benefits under part B of title XVIII of 
the Social Security Act. 
(3) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
TITLE 
II—STRENGTHENING 
MEDICARE 
SECONDARY 
PAYER RULES 
SEC. 201. DETERMINATION OF REIMBURSEMENT AMOUNT 
THROUGH CMS WEBSITE TO IMPROVE PRO-
GRAM EFFICIENCY. 
Section 1862(b)(2)(B) of the Social Security Act (42 
U.S.C. 1395y(b)(2)(B)) is amended by adding at the end 
the following new clause:
‘‘(vii) USE OF WEBSITE TO DETER-
MINE
FINAL
CONDITIONAL
REIMBURSE-
MENT AMOUNT.— 
‘‘(I) NOTICE TO SECRETARY OF 
EXPECTED DATE OF A SETTLEMENT, 
JUDGMENT, ETC.—In the case of a 
payment made by the Secretary pur-
suant to clause (i) for items and serv-
ices provided to the claimant, the 
claimant or applicable plan (as de-
fined in paragraph (8)(F)) may at 
any time beginning 120 days before 
the reasonably expected date of a set-
tlement, judgment, award, or other 
payment, notify the Secretary that a 
payment is reasonably expected and 
the expected date of such payment. 
‘‘(II) SECRETARIAL
PROVIDING 
ACCESS
TO
CLAIMS
INFORMATION 
THROUGH
A
WEBSITE.—The Sec-
retary shall maintain and make avail-
able to individuals to whom items and 
services are furnished under this title 
(and to authorized family or other 
representatives recognized under regu-