Senator John Kerry Introduces IVIg Access Legislation

Senator John Kerry (D-MA), primary author of S. 2990, The Medicare IVIG Access Act

In recognition of the continuing Medicare reimbursement problems that are affecting access to IVIg, United States Senator John Kerry (D-MA), along with Senators Debbie Stabenow (D-MI) and Lamar Alexander (R-TN) have introduced S. 2990, The Medicare IVIg Access Act. This legislation is similar to an existing bill introduced last year (HR 2914) in the House of Representatives by Kevin Brady (R-TX). Both pieces of legislation are assigned to the committees that have oversight for the Medicare program in each chamber of the Congress.

Senator Kerry’s bill is referred to the Senate Finance Committee while Representative Brady’s bill is assigned to the House Ways and Means Committee. Senator Kerry has also pledged to seek inclusion of this legislation within a larger Medicare package currently being formulated. In practical terms, S. 2990 needs to be incorporated into this larger package in order to be enacted into law.

Moreover, the Medicare package needs to be enacted by June 30 in order to avoid mandatory budget cuts of nearly 11% in physician services reimbursement across Medicare. It is expected that Congress will address this through the passage of a Medicare package; although it could slip beyond June 30 in which case a retroactive adjustment would occur.

The Medicare IVIg Access Act Specifically Provides for Two Measures:

1) The creation under Medicare of an additional payment to be added to the reimbursement rate for IVIg. This is based on a similar precedent for blood clotting factors. The additional payment would be specific to the reimbursement of the IVIg product when used in the treatment of any Medicare covered condition.

2) This legislation would also extend Medicare home infusion coverage for items and services associated with IVIg administration for primary immune deficiency. At present, the therapy is covered under Part B in the home, but not the items and services associated with administration. This has resulted in many home infusion providers being unable to afford providing services to Medicare beneficiaries with primary immune deficiency. Home infusion coverage is covered by many Part D prescription drug plans in cases of off-label but medically indicated uses for IVIg, however home infusion for primary immune Medicare beneficiaries is restricted to Part B, thereby precluding Part D as an alternative. S. 2990 would correct this discrepancy and ensure that primary immune deficient Medicare beneficiaries also have access to home infusion treatment.

Both Senator Kerry and Senator Stabenow serve on the Finance Committee, which has jurisdiction in putting together the Medicare package for the Senate. Senator Kerry states, “Our bill will fix this error (in Medicare reimbursement) so patients can stop worrying about navigating red tape and start getting the treatment they need.”

A copy of the press release issued by Senator Kerry can be obtained by clicking on the following link or copying and pasting this URL in your web browser: http://kerry.senate.gov/cfm/record.cfm?id=297377.

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