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Medicare Coverage for Immune Deficiency Care at Home Advanced by House

The House passed a bill Wednesday that would establish a demonstration project to evaluate the benefits of allowing Medicare to cover in-home intravenous treatments for patients with primary immune deficiency disease.

The disease leaves patients unable to produce protective antibodies or develop immunity, requiring infusions of intravenous immunoglobulin to help them fight infections. Changes in Medicare reimbursement policy have had the unintended consequence of limiting the access of many beneficiaries to this lifesaving treatment.

Bill sponsor Kevin Brady, R-Texas, has said the bill would “make whole the home infusion benefit for patients with primary immune deficiencies.”

The proposal (HR 1845), passed 401-3 under suspension of the rules, garnered wide bipartisan support in the House, with more than 40 Democrats and more than two dozen Republicans signing on as co-sponsors to Brady’s bill. Proponents contend the legislation is needed to enhance therapeutic innovation and further patient access to plasma protein therapies.

The demonstration project would begin one year after enactment and be capped at 4,000 beneficiaries. Within two years, the Department of Health and Human Services would report on any access and reimbursement issues, including the appropriateness of a new Medicare payment methodology.

By Anna McGeehan, CQ Roll Call, CQ NEWS - Dec. 19, 2012 – 2:39 p.m.

Robert Tomkin contributed to this story.

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