H.R.1143 - Medicare IVIG Access Enhancement Act of 2025 (119th Congress)
Summary
H.R.1143, the Medicare IVIG Access Enhancement Act of 2025, aims to amend Title XVIII of the Social Security Act to expand Medicare coverage for in-home administration of intravenous immune globulin (IVIG). Specifically, it extends coverage to include treatment for chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy, beginning January 1, 2027. The bill also allows for variance in payments based on the specific condition being treated, as determined by the Secretary through rulemaking.
Expected Effects
The bill will broaden access to in-home IVIG therapy for individuals with chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy under Medicare. This expansion could improve patient outcomes and reduce the burden of frequent hospital visits. The Secretary's authority to vary payments may lead to adjustments in reimbursement rates for IVIG administration based on the treated condition.
Potential Benefits
- Increased access to necessary treatment for individuals with specific neurological conditions.
- Potential for improved patient outcomes through in-home administration.
- Reduced burden on patients and healthcare facilities by shifting treatment to the home setting.
- Possible cost savings due to potentially more efficient in-home administration.
- Clarification of payment structures for IVIG administration under Medicare.
Potential Disadvantages
- Increased Medicare spending, potentially impacting the program's long-term financial stability.
- Potential for fraud or abuse related to in-home administration of IVIG.
- Administrative burden on the Secretary to establish appropriate payment variances.
- Possible disparities in access to in-home IVIG based on geographic location or other factors.
- The effective date of January 1, 2027, delays immediate access for those who need it.
Most Disadvantaged Areas:
Constitutional Alignment
The bill falls under the purview of Congress's power to legislate on matters related to healthcare and the general welfare, as outlined in Article I, Section 8 of the US Constitution. Specifically, it amends Title XVIII of the Social Security Act, which is a long-standing exercise of congressional authority in providing for social welfare programs. There is no apparent conflict with any specific constitutional provision.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).