[Congressional Record (Bound Edition), Volume 152 (2006), Part 16]
[Extensions of Remarks]
[Page 21743]
[From the U.S. Government Publishing Office, www.gpo.gov]




    URGING THE CENTERS FOR MEDICARE AND MEDICAID TO RECONSIDER IVIG 
                             REIMBURSEMENT

                                 ______
                                 

                          HON. CHARLIE NORWOOD

                               of georgia

                    in the house of representatives

                       Friday, September 29, 2006

  Mr. NORWOOD. Mr. Speaker, I would like to bring your attention to a 
very important issue relating to medical reimbursement by the Centers 
for Medicare and Medicaid Services (CMS). The Medicare Prescription 
Drug Improvement Act and Modernization Act of 2003 (MMA) created new 
reimbursement mechanisms for IVIG therapies. CMS's implementation of 
the MMA has resulted in reduced access to life-saving therapies for 
Medicare beneficiaries. CMS potentially closed the door to medical 
treatment when they issued the CY 2007 proposed rules for the physician 
fee schedule and the hospital outpatient prospective payment system, 
which, if implemented, would effectively limit IVIG treatment by not 
properly reimbursing providers.
  IVIG is a vital medical service. It is a plasma-derived therapy 
tailored to the individual's diseases and treatment options to achieve 
optimal results. Nearly 10,000 Medicare beneficiaries are afflicted 
with primary immune deficiency (PID) which only responds to IVIG 
therapy. For many Americans there is no substitute for IVIG treatment.
  More to the point, this treatment allows individuals to carry on 
normal daily-life activities. PID requires IVIG therapy every 3 to 4 
weeks for the duration of an individual's life, but without such 
treatment the individual not only imposes additional medical costs on 
an already overburdened system, they cease to be active members of our 
society. Such an outcome is simply not acceptable. IVIG therapy is 
cost-effective and beneficial for the patient. As far as I am 
concerned, that should be enough to get CMS to rethink implementing any 
reimbursement change that has the potential to harm access and reduce 
medical outcomes.
  In May of this year, thirty-five members of Congress, including 
myself, sent a letter to Secretary Leavitt of the Department of Health 
and Human Services expressing our concern over this matter and 
encouraged Secretary Leavitt to consider a payment adjustment, combined 
with product specific reimbursement. We also made clear that we would 
be open to any other mechanism he may have deemed suitable in order to 
resolve this patient access dilemma. Secretary Leavitt's response was, 
quite simply, inadequate. He failed to address our specific concerns or 
pose alterative remedies that would allow patients continued access to 
IVIG treatment.
  I urge CMS to reconsider its actions in this case to ensure patient 
access to a necessary and legitimate medical treatment.

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