[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 960 Introduced in Senate (IS)]

112th CONGRESS
  1st Session
                                 S. 960

  To provide for a study on issues relating to access to intravenous 
immune globulin (IVIG) for Medicare beneficiaries in all care settings 
   and a demonstration project to examine the benefits of providing 
  coverage and payment for items and services necessary to administer 
                           IVIG in the home.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 12, 2011

 Mr. Kerry (for himself, Mr. Alexander, and Mr. Wyden) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
  To provide for a study on issues relating to access to intravenous 
immune globulin (IVIG) for Medicare beneficiaries in all care settings 
   and a demonstration project to examine the benefits of providing 
  coverage and payment for items and services necessary to administer 
                           IVIG in the home.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare IVIG Access Act''.

SEC. 2. MEDICARE PATIENT IVIG ACCESS DEMONSTRATION PROJECT.

    (a) Establishment.--The Secretary shall establish and implement a 
demonstration project under title XVIII of the Social Security Act to 
evaluate the benefits of providing payment for items and services 
needed for the administration, within the homes of Medicare 
beneficiaries, of intravenous immune globin for the treatment of 
primary immune deficiency diseases.
    (b) Duration and Scope.--
            (1) Duration.--Beginning not later than 6 months after the 
        date of enactment of this Act, the Secretary shall conduct the 
        demonstration project for a period of 3 years.
            (2) Scope.--The Secretary shall enroll not greater than 
        4,000 Medicare beneficiaries who have been diagnosed with 
        primary immunodeficiency disease for participation in the 
        demonstration project. A Medicare beneficiary may participate 
        in the demonstration project on a voluntary basis and may 
        terminate participation at any time.
    (c) Reimbursement.--The Secretary shall establish an hourly rate 
for payment for items and services needed for the administration of 
intravenous immune globin based on the low-utilization payment 
adjustment under the prospective payment system for home health 
services established under section 1895 of the Social Security Act (42 
U.S.C. 1395fff).
    (d) Study and Report to Congress.--
            (1) Interim evaluation and report.--Not later than 24 
        months after the date of enactment of this Act, the Secretary 
        shall submit to Congress a report that contains the following:
                    (A) An interim evaluation of the impact of the 
                demonstration project on access for Medicare 
                beneficiaries to items and services needed for the 
                administration of intravenous immune globin within the 
                home.
                    (B) An analysis of the appropriateness of 
                implementing a new methodology for payment for 
                intravenous immune globulins in all care settings under 
                part B of title XVIII of the Social Security Act (42 
                U.S.C. 1395k et seq.).
                    (C) An analysis of the feasibility of reducing the 
                lag time with respect to data used to determine the 
                average sales price under section 1847A of the Social 
                Security Act (42 U.S.C. 1395w-3a).
                    (D) An update to the report entitled ``Analysis of 
                Supply, Distribution, Demand, and Access Issues 
                Associated with Immune Globulin Intravenous (IGIV)'', 
                issued in February 2007 by the Office of the Assistant 
                Secretary for Planning and Evaluation of the Department 
                of Health and Human Services.
            (2) Final evaluation and report.--Not later than July 1, 
        2015, the Secretary shall submit to Congress a report that 
        contains a final evaluation of the impact of the demonstration 
        project on access for Medicare beneficiaries to items and 
        services needed for the administration of intravenous immune 
        globin within the home.
    (e) Offset.--
            (1) In general.--Section 1861(n) of the Social Security Act 
        (42 U.S.C. 1395x(n)) is amended by adding at the end the 
        following: ``Such term includes disposable drug delivery 
        systems, including elastomeric infusion pumps, for the 
        treatment of colorectal cancer.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall apply to items furnished on or after the date of 
        enactment of this Act.
    (f) Definitions.--In this Act:
            (1) Demonstration project.--The term ``demonstration 
        project'' means the demonstration project conducted under this 
        Act.
            (2) Medicare beneficiary.--The term ``Medicare 
        beneficiary'' means an individual who is entitled to, or 
        enrolled for, benefits under part A of title XVIII of the 
        Social Security Act or enrolled for benefits under part B of 
        such title.
            (3) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
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