Three Reasons to Support H.R. 2914, Medicare IVIG Access Act of 2007

In January 2005, legislation changed the way Medicare paid for intravenous immune globulin (IVIG). This change impacted all Medicare patients who need IVIG, because the Medicare payment is often below the actual costs of purchasing IVIG. This change had the unintended consequence of compromising patient access to IVIG because many physicians and hospital outpatient departments could no longer afford to treat Medicare patients needing IVIG. The struggle continues today.

After two years of advocating to restore access to IVIG for Medicare patients in all sites of care, IDF played a leadership role in initiating legislative action. In June 2007, Representative Kevin Brady and others introduced H.R. 2914, the “Medicare IVIG Access Act,” a bipartisan bill to help ALL patients who rely on IVIG.   

Three Reasons to Support H.R. 2914

The bill does not tell the Secretary what that rate should be.  Rather, it directs the Secretary to review existing data and to collect additional data related to the unique characteristics of IVIG. Then, if appropriate, the Secretary can adjust the payment to cover the costs of IVIG within seven months of enactment of the bill. 

Regardless of how the Secretary of HHS may change Medicare’s payment for IVIG under H.R. 2914, it is necessary to monitor access for beneficiaries to determine if existing problems are ameliorated, persist, or become worse. This bill requires the Secretary to conduct two beneficiary surveys over three years to measure changes in patient access, as well as changes in health outcomes.

There is a Medicare home infusion benefit specific to patients with primary immune deficiency disease (PIDD) that is covered under Medicare Part B.  However, this provision covers only the purchase of the product. It does not cover the costs of administering the product in the home or the costs of the home nursing and equipment required.  When Medicare reimbursement was lowered in Medicare Part B, home health companies could no longer afford to treat PIDD patients, making this an empty benefit.  All other Medicare patients who need IVIG are eligible for home infusion through Medicare’s prescription drug program under Part D, and many providers can still afford to treat these patients.  Because of the current reimbursement situation, only PIDD patients are excluded from receiving home infusion – a patient population that must avoid unnecessary exposure to infection in other healthcare settings.

Now is the time for the entire IVIG community to act.
Contact your U.S. Representative and Senators
to ask for a solution to the IVIG access problem.

Support of H.R. 2914, Medicare IVIG Access Act of 2007
H.R. 2914 is supported by the Immune Deficiency Foundation, the Jeffrey Modell Foundation, GBS/CIDP Foundation International, the Platelet Disorder Support Association, the Clinical Immunology Society, the Plasma Protein Therapeutics Association, ASD Healthcare and Accredo Therapeutics, and the National Patient Advocate Foundation. 

H.R. 2914 was introduced by Rep. Kevin Brady, and currently 25 other Members of Congress – Democrats and Republicans – have co-sponsored the bill.  During the mark-up of the CHAMP bill (Children’s Health and Medicare Protection Act), the Democratic and Republican leaders of the House Ways and Means Committee, which has jurisdiction over Medicare, recognized the access problems many patients needing IVIG are having.  They agreed to work together to find a mutually satisfactory solution to these problems.  The Senate is poised to act on a variety of Medicare issues, providing an opportunity to include an IVIG solution in legislation this year.