IVIG Access & Reimbursement
The primary immunodeficiency community is experiencing delays in and denial of treatment due to insufficient Medicare reimbursement. An April 2007 report from the Office of the Inspector General showed Medicare reimbursement for IVIG is lower than the cost many providers pay for the product. As a result, many physicians and hospital outpatient units cannot afford to administer IVIG treatment to Medicare patients. This serious problem affects the entire community as an increasing number of private pay insurers are starting to follow Medicare's lead to determine reimbursement rates for IVIG.
To fix this problem, legislation has been introduced into both the House of Representatives and the Senate. The Senate bill, S. 2990, was introduced by Senators John Kerry (MA), Lamar Alexander (TN) and Debbie Stabenow (MI), and the House bill, H.R. 2914, by Congressman Kevin Brady (TX). This legislation, known as the "Medicare IVIG Access Act", offers a solution to the current IVIG access crisis by setting up a process for evaluating reimbursement policy for IVIG to determine when adjustments to payment are appropriate. It also changes current policy regarding Medicare coverage of home infusion to include the cost of items and services related to the administration of IVIG in the home.
With the support of our patient community and the strong leadership of the many policymakers who have signed on to support this legislation, we hope to successfully improve access to treatment and the quality of life of the countless patients who struggle with negative health outcomes, increased intervals of care, change in site of infusion, difficulty finding providers, and denial of treatment.
However, we can't do it alone! Insufficient reimbursement for IVIG is a serious problem affecting more and more patients every day. Please visit the IDF Action Alert to tell your legislators how important IVIG is to you and your loved ones and ask them to fix the Medicare IVIG access and reimbursement issue.
To learn more about H.R. 2914 and S. 2990, click on the links below.
Senate Bill, S. 2990
House of Representatives Bill, H.R. 2914