[Congressional Record Volume 155, Number 51 (Wednesday, March 25, 2009)]
[Senate]
[Pages S3792-S3793]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KERRY (for himself, Mr. Alexander, Mr. Wyden, Mr. 
        Whitehouse, and Mr. Brownback):
  S. 701 A bill to amend title XVIII of the Social Security Act to 
improve access of Medicare beneficiaries to intravenous immune 
globulins (IVI); to the Committee on Finance.
  Mr. KERRY. Mr. President, as we move forward with comprehensive 
health reform we must also not ignore that some of our most vulnerable 
Medicare beneficiaries are subject to costly, bureaucratic red tape 
which is delaying

[[Page S3793]]

essential, life-saving treatments. Addressing this problem can both 
increase the quality of life for many patients and ease financial 
burdens for their medical providers.
  Between 6,000 and 10,000 Medicare beneficiaries have primary 
immunodeficiency diseases, PIDD, that require intravenous 
immunoglobulin, IVIG, treatment to maintain a healthy immune system.
  Primary Immunodeficiency Diseases, PIDD, are disorders in which part 
of the body's immune system is missing or does not function properly. 
Untreated PIDDs result in frequent life-threatening infections and 
debilitating illnesses. Even illnesses such as the common cold or the 
flu can be deadly for someone with PIDD.
  Because of advances in our medical understanding and treatment of 
primary immune deficiency diseases, individuals who in the past would 
not have survived childhood are now able to live nearly normal lives. 
While there is still no cure for PIDD, there are effective treatments 
available. Nearly 70 percent of primary immune deficient patients use 
intravenous immunoglobulin, IVIG, to maintain their health.
  Immunoglobulin is a naturally occurring collection of highly 
specialized proteins, known as antibodies, which strengthen the body's 
immune response. It is derived from human plasma donations and is 
administered intravenously to the patient every three to four weeks.
  Currently, Medicare beneficiaries needing IVIG treatments are 
experiencing access problems. This is an unintended result of the way 
Medicare has determined the payment for IVIG. In January 2005, the 
Medicare Modernization Act changed the way physicians and hospital 
outpatient departments were paid under Medicare. The law reduced IVIG 
reimbursement rates so most physicians in outpatient settings could no 
longer afford to treat Medicare patients requiring IVIG. Access to home 
based infusion therapy is limited since Medicare currently pays for the 
cost of IVIG, but not for the nursing services or supplies required for 
infusion.
  As a result, patients are experiencing delays in receiving 
critically-needed treatment and are being shifted to more expensive 
care settings such as inpatient hospitals. In April 2007, the U.S. 
Department of Health and Human Services Office of the Inspector 
General, OIG, reported that Medicare reimbursement for IVIG was 
inadequate to cover the cost many providers must pay for the product. 
In fact, the OIG found that 44 percent of hospitals and 41 percent of 
physicians were unable to purchase IVIG at the Medicare reimbursement 
rate during the 3rd quarter of 2006. The previous quarter was even 
worse--77.2 percent of hospitals and 96.5 percent of physicians were 
unable to purchase IVIG at the Medicare reimbursement rate.
  We have an opportunity to fix this very real problem with a 
compassionate and common sense solution. I believe we can improve the 
quality of life for PIDD patients and cut inpatient expenses by 
improving reimbursement procedures for IVIG treatments for physicians 
and outpatient facilities and allowing for home treatments and coverage 
for related services.
  That is why, today, I am introducing the Medicare IVIG Access Act, 
with Senators Alexander, Wyden, Whitehouse, and Brownback, to authorize 
the Secretary of Health and Human Services to update the payment for 
IVIG, based on new or existing data, and to provide coverage for 
related items and services currently excluded from the existing 
Medicare home infusion therapy benefit. This bill is endorsed by 
several national organizations from the patient and physician 
communities, including the Immune Deficiency Foundation, GBS/CIDP 
Foundation International, the Jeffrey Modell Foundation, the Clinical 
Immunology Society, and the National Patient Advocate Foundation.
  I hope all my colleagues can support this legislation to help 
patients, physicians, caretakers, researchers, and plasma donors.
                                 ______