I 
117TH CONGRESS 
2D SESSION 
H. R. 7346 
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. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 31, 2022 
Ms. SALAZAR (for herself and Ms. PINGREE) 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 subse-
quently 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 provide 
for coverage and payment of Alpha-1 Antitrypsin Defi-
ciency Disorder treatment under part B of such title, 
and for other purposes. 
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 ‘‘John W. Walsh Alpha- 
1 Home Infusion Act of 2022’’. 
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SEC. 2. MEDICARE COVERAGE OF ALPHA-1 ANTITRYPSIN 
DISORDER TREATMENT. 
(a) IN GENERAL.—Section 1861 of the Social Secu-
rity Act (42 U.S.C. 1395x) is amended— 
(1) in subsection (s)(2)— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (GG); 
(B) by inserting ‘‘and’’ at the end of sub-
paragraph (HH); and 
(C) by inserting at the end the following 
new subparagraph: 
‘‘(II) Alpha-1 Antitrypsin Deficiency Dis-
order treatment (as defined in subsection 
(lll));’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(lll) ALPHA-1
ANTITRYPSIN
DEFI-
CIENCY DISORDER TREATMENT.—(1) The 
term ‘Alpha-1 Antitrypsin Deficiency Dis-
order treatment’ means augmentation ther-
apy (as defined in paragraph (2)(C)) fur-
nished 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— 
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‘‘(A) who is under the care of an applicable 
provider; 
‘‘(B) 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 
‘‘(C) who requires augmentation therapy 
(as defined in paragraph (2)(C)). 
‘‘(2) For purposes of this subsection: 
‘‘(A) 
The 
term 
‘applicable 
provider’ 
means— 
‘‘(i) a physician; 
‘‘(ii) a nurse practitioner; and 
‘‘(iii) a physician assistant. 
‘‘(B) The term ‘home’ means a place of 
residence used as the home of an individual (as 
defined for purposes of subsection (n)). 
‘‘(C) The term ‘augmentation therapy’ 
means an Alpha-1 Proteinase Inhibitor indi-
cated for chronic augmentation and mainte-
nance therapy in adults with clinical evidence of 
emphysema due to severe hereditary deficiency 
of Alpha-1 Antitrypsin. 
‘‘(D) The term ‘qualified home infusion 
therapy supplier’ has the meaning given such 
term in subsection (iii)(3)(D)(i).’’. 
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(b) PAYMENT FOR INTRAVENOUS ADMINISTRATION 
KITS
AND
NURSING
SERVICES
FOR
ALPHA-1 
ANTITRYPSIN
DEFICIENCY
DISORDER
TREATMENT.— 
Section 1834 of the Social Security Act (42 U.S.C. 
1395m) is amended by adding at the end the following 
new subsection: 
‘‘(z) PAYMENT FOR INTRAVENOUS ADMINISTRATION 
KITS
AND
NURSING
SERVICES
FOR
ALPHA-1 
ANTITRYPSIN DEFICIENCY DISORDER TREATMENT.—The 
Secretary shall implement a payment system under which 
payment is made under this title to a qualified home infu-
sion 
therapy 
supplier 
(as 
defined 
in 
section 
1861(lll)(3)(D)) for intravenous administration kits and 
nursing services for up to 2 hours of care by a qualified 
home infusion therapy supplier in coordination with the 
furnishing of augmentation therapy (as defined in section 
1861(lll)(2)(C)).’’. 
(c) CONFORMING AMENDMENTS.— 
(1) 
PAYMENT
REFERENCE.—Section 
1833(a)(1) of the Social Security Act (42 U.S.C. 
1395l(a)(1)) is amended— 
(A) by striking ‘‘and’’ before ‘‘(DD)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (EE) with respect 
to intravenous administration kits and nursing 
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services described in section 1834(z) for Alpha- 
1 Antitrypsin Disorder treatment (as defined in 
subsection (lll)(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(z)’’. 
(2) DIRECT PAYMENT.—The first sentence of 
section 1842(b)(6) of the Social Security Act (42 
U.S.C. 1395u(b)(6)) is amended— 
(A) by striking ‘‘and’’ before ‘‘(J)’’; and 
(B) by inserting before the period at the 
end the following: ‘‘, and (K) in the case of in-
travenous administration kits and nursing serv-
ices described in section 1834(z), payment shall 
be made to the qualified home infusion therapy 
supplier 
(as 
defined 
in 
section 
1861(lll)(2)(D))’’. 
(3) EXCLUSION
FROM
HOME
HEALTH
SERV-
ICES.—Section 1861(m) of the Social Security Act 
(42 U.S.C. 1395x(m)) is amended, in the first sen-
tence, by inserting the following before the period at 
the end: ‘‘and intravenous administration kits and 
nursing services described in section 1834(z) for 
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Alpha-1 Antitrypsin Deficiency Disorder treatment 
(as defined in subsection (lll)(1))’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2023. 
Æ 
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