PAVE Act
H.R. 5736, the Penicillin Allergy Verification and Evaluation Act (PAVE Act), would amend title XVIII of the Social Security Act to add penicillin allergy verification and evaluation to Medicare’s initial preventive physical examination (IPPE) and to the annual wellness visit (AWV). Introduced in the 119th Congress, the bill proposes that Medicare beneficiaries receive a structured process during IPPEs and AWVs to identify individuals with a penicillin allergy history, assess whether their reported reaction truly reflects an allergy, inform patients about the impact of a penicillin allergy label, and refer appropriate cases to an allergy/immunology specialist. The amendments would apply to examinations and visits on or after January 1, 2027, and they would not prohibit separate payment for these services when provided the same day as an IPPE or AWV. The bill’s findings emphasize that most people with self-reported penicillin allergies can safely receive penicillin after verification, with potential benefits for antibiotic stewardship and health outcomes.
Key Points
- 1Adds penicillin allergy verification and evaluation to Medicare’s IPPE and AWV, with a defined scope and process.
- 2The service includes: identifying individuals reporting penicillin allergy, evaluating whether the history matches an true allergy, informing patients about the health impact of an allergy label, and referring to an allergy/immunology specialist when appropriate.
- 3The rule of construction ensures that this verification and evaluation could be paid separately if furnished on the same day as an IPPE or AWV.
- 4Effective date: applies to examinations and visits on or after January 1, 2027.
- 5The bill cites findings supporting delabeling penicillin allergy as a cost-saving and health-improving measure, citing evidence that many self-reported penicillin allergies are not true allergies and that verification can improve outcomes and antibiotic stewardship.