Questions about the Medicare Home IVIG Demonstration Project and how it will transition to a permanent benefit? Check out IDF's Medicare Home IVIG Benefit: Frequently Asked Questions.
On December 23, 2022, Congress passed legislation making payment for the services and supplies needed for home infusions of intravenous immunoglobulin (IVIG) a permanent Medicare benefit for those with primary immunodeficiency (PI). The move comes nearly a decade after then-President Obama signed the Medicare IVIG Access Act (HR 1845) into law, creating the initial Medicare IVIG demonstration project. The current extension of the demonstration project is set to end on December 31, 2023, with the new legislation taking effect starting January 1, 2024.
The passage of a permanent bundled Medicare payment that includes the immunoglobulin (Ig) medication, the supplies, and the nursing services needed to administer IVIG at home corrects a long-standing hole in Medicare Part B. Medicare Part B includes a special provision for patients with PI to receive home infusions of IVIG, but only covered the cost of the Ig product itself. Beneficiaries either had to pay for the supplies and services needed out of pocket or opt to receive their infusions in an outpatient setting, where services and supplies were covered.
IDF has been working to address the Medicare home IVIG hole for many years, championing the demonstration project and its two extensions. Advocates from the PI community have been integral in putting faces to the issue and maintaining steady pressure to address it with permanent legislation. The new benefit is structured in the same way as the demonstration project, but is open to anyone on Medicare Part B with primary immunodeficiency and does not require special enrollment.
“This is a huge win for IDF and the primary immunodeficiency community. For 10 years, medicare beneficiaries in need of IVIG have benefited from receiving home infusions through the Medicare IVIG demonstration. Now our community has a permanent benefit without needing to enroll in a time-limited demonstration,” said Lynn Albizo, IDF’s vice president of public policy.
A recent interim report on the demonstration project from the Centers for Medicaid and Medicare Services (CMS) showed evidence of better overall health for enrollees, who reported better access to their IVIG treatments. These results are in line with studies that show home IVIG infusions are preferred by patients for a number of reasons, including reduced exposure to the germs found in outpatient settings. Services and supplies for home IVIG infusions have also long been covered by private insurers.
Albizo acknowledged the work of legislative partners in getting the permanent benefit passed. “We applaud IDF legislative champions, Representatives Kevin Brady (R) and Doris Matsui (D) for working tirelessly on the home IVIG benefit for over 10 years. Your efforts have truly benefited the PI community. We will miss Representative Brady in Congress, and the PI community will be forever grateful for his work on our behalf,” she said.