Title: Medicare IVIG Access Enhancement Act
Policy area: Health

Summary:
Medicare IVIG Access Enhancement Act
This bill requires the Centers for Medicare & Medicaid Services to establish a three-year demonstration project to evaluate the benefits of providing Medicare coverage and payment for items and services needed for the in-home administration of intravenous immune globulin to treat chronic inflammatory demyelinating polyneuropathy or multifocal motor neuropathy. Beneficiary participation shall be voluntary.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4724 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 4724

To provide for a demonstration project to further examine the benefits 
 of providing coverage and payment for items and services necessary to 
  administer intravenous immune globulin (IVIG) in the home, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           December 21, 2017

 Mr. Holding (for himself, Mr. Blumenauer, Mr. Lance, Mr. Butterfield, 
 and Mr. Meehan) 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 provide for a demonstration project to further examine the benefits 
 of providing coverage and payment for items and services necessary to 
  administer intravenous immune globulin (IVIG) in the home, and for 
                            other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare IVIG Access Enhancement 
Act''.

SEC. 2. MEDICARE PATIENT IVIG ACCESS DEMONSTRATION PROJECT.

    (a) Establishment.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall establish and 
implement a demonstration project under part B of title XVIII of the 
Social Security Act to evaluate the benefits of providing payment for 
items and services needed for the in-home administration of intravenous 
immune globulin for the treatment of chronic inflammatory demyelinating 
polyneuropathy or multifocal motor neuropathy.
    (b) Duration and Scope.--
            (1) Duration.--Beginning not later than 1 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 greater than 
        3,000 Medicare beneficiaries who have been diagnosed with 
        chronic inflammatory demyelinating polyneuropathy or multifocal 
        motor neuropathy for participation in the demonstration 
        project. A Medicare beneficiary may participate in the 
        demonstration project on a voluntary basis and may terminate 
        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 Security Act in the same manner as similar items and services 
covered under such part.
    (d) Payment.--
            (1) Intravenous immune globulin.--For intravenous immune 
        globulin furnished under this section, the Secretary shall make 
        payment using the payment methodology under section 1847A of 
        the Social Security Act (42 U.S.C. 1395w-3a).
            (2) Other items and services.--
                    (A) In general.--The Secretary shall establish, 
                subject to subparagraph (B), a per-visit payment amount 
                for items and services (other than intravenous immune 
                globulin) needed for the in-home infusion of 
                intravenous immune globulin for the treatment of 
                chronic inflammatory demyelinating polyneuropathy or 
                multifocal motor neuropathy 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 Social Security 
                Act (42 U.S.C. 1395fff).
                    (B) Limitation.--The per-visit payment amount 
                established under subparagraph (A) for items and 
                services described in such subparagraph shall not be 
                less than the payment amount applied under the 
                demonstration project established under section 101 of 
                the Medicare IVIG Access and Strengthening Medicare and 
                Repaying Taxpayers Act of 2012 (Public Law 112-242) for 
                comparable items and services needed for the in-home 
                administration of intravenous immune globulin for the 
                treatment of primary immune deficiency diseases.
    (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) Reports to Congress.--
            (1) Interim evaluation and report.--Not later than 3 years 
        after the date of enactment of this Act, the Secretary shall 
        submit to Congress a report that contains--
                    (A) an evaluation of the impact of the 
                demonstration project on access for Medicare 
                beneficiaries with chronic inflammatory demyelinating 
                polyneuropathy and Medicare beneficiaries with 
                multifocal motor neuropathy to items and services 
                needed for the in-home administration of intravenous 
                immune globin; and
                    (B) an analysis of the appropriateness of expanding 
                or extending the demonstration project or implementing 
                a new methodology for payment for intravenous immune 
                globulins in all care settings under part B of title 
                XVIII of the Social Security Act (42 U.S.C. 1395k et 
                seq.) and, to the extent such analysis determines such 
                an expansion, extension, or methodology appropriate, 
                recommendations for such expansion, extension, or 
                methodology, respectively.
            (2) Final evaluation and report.--Not later than one year 
        after the date of completion of the demonstration project, the 
        Secretary shall submit to Congress a report that contains--
                    (A) a final evaluation of the impact described in 
                paragraph (1)(A); and
                    (B) a final analysis and recommendations described 
                in paragraph (1)(B).
    (g) Definitions.--In this section:
            (1) Demonstration project.--The term ``demonstration 
        project'' means the demonstration project conducted under this 
        Act.
            (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.
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