[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1765 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 1765

To amend title XVIII of the Social Security Act with respect to payment 
for the furnishing of intravenous immune globulin (IVIG) in a patient's 
  home for the treatment of primary immune deficiency diseases and to 
cover certain disposable pumps as durable medical equipment in place of 
            non-disposable pumps under the Medicare Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 26, 2009

Ms. Matsui (for herself and Mr. Tanner) introduced the following bill; 
  which was referred to the Committee on Energy and Commerce, and in 
    addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act with respect to payment 
for the furnishing of intravenous immune globulin (IVIG) in a patient's 
  home for the treatment of primary immune deficiency diseases and to 
cover certain disposable pumps as durable medical equipment in place of 
            non-disposable pumps under the Medicare Program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. MEDICARE PAYMENT FOR ITEMS AND SERVICES RELATING TO THE 
              FURNISHING OF INTRAVENOUS IMMUNE GLOBULIN (IVIG) IN A 
              PATIENT'S HOME FOR THE TREATMENT OF PRIMARY IMMUNE 
              DEFICIENCY DISEASES.

    (a) Coverage.--Section 1861 of the Social Security Act (42 U.S.C. 
1395x) is amended--
            (1) in subsection (s)(2)(Z) by inserting ``and items and 
        services related to the administration of intravenous immune 
        globulin'' after ``globulin''; and
            (2) in subsection (zz), by striking ``, but not including 
        items or services related to the administration of the 
        derivative,''.
    (b) Payment.--Section 1842(o) of such Act (42 U.S.C. 1395u(o)) is 
amended--
            (1) in paragraph (7)--
                    (A) by striking ``(6)'' and inserting ``(7)''; and
                    (B) by redesignating such paragraph as paragraph 
                (8); and
            (2) by inserting after paragraph (6) the following new 
        paragraph:
    ``(7)(A) Subject to subparagraph (B), in the case of intravenous 
immune globulins furnished on or after January 1, 2010, under section 
1861(s)(2)(Z), the Secretary shall provide for a separate payment for 
items and services related to the administration of such intravenous 
immune globulins in an amount that the Secretary determines to be 
appropriate based on a review of available published and unpublished 
data and information, including the Study of Intravenous Immune 
Globulin Administration Options: Safety, Access, and Cost Issues (CMS 
Contract #500-95-0059). Such payment amount may take into account the 
following:
            ``(i) Pharmacy overhead and related expenses.
            ``(ii) Patient service costs.
            ``(iii) Supply costs.
    ``(B) The separate payment amount under this paragraph for 
intravenous immune globulins furnished in 2011 or a subsequent year 
shall be equal to the separate payment amount determined under this 
paragraph for the previous year increased by the percentage increase in 
the consumer price index for medical care for the 12-month period 
ending with June of the previous year.''.

SEC. 2. MEDICARE COVERAGE OF DISPOSABLE PUMPS AS ITEMS OF DURABLE 
              MEDICAL EQUIPMENT IN CERTAIN CASES.

    (a) In General.--Section 1861(n) of the Social Security Act (42 
U.S.C. 1395x(n)) is amended by inserting before the semicolon the 
following: ``and includes a disposable pump prescribed, instead of a 
non-disposable external infusion pump, for administration of a drug 
used as part of a chemotherapy regimen for the treatment of colorectal 
cancer if a non-disposable external infusion pump would have been 
covered under this subsection to administer the same drug for the same 
indication as of July 1, 2008''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to disposable pumps furnished on or after January 1, 2010.
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