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HR 1143119th CongressIn Committee

Medicare IVIG Access Enhancement Act of 2025

Introduced: Feb 7, 2025
Standard Summary
Comprehensive overview in 1-2 paragraphs

Medicare IVIG Access Enhancement Act of 2025 would expand Medicare coverage for in-home administration of intravenous immune globulin (IVIG). Specifically, it would add coverage for two additional conditions—chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN)—for home IVIG starting January 1, 2027 (in addition to the existing coverage for primary immune deficiency diseases). The bill also authorizes that payments for home IVIG could vary depending on the treated condition, with the Secretary allowed to determine, through notice-and-comment rulemaking, whether billing and payment should differ for PIDD versus CIDP/MMN. Overall, the bill aims to broaden access to at-home IVIG therapy and adjust reimbursements to reflect different indications.

Key Points

  • 1Expands Medicare coverage for in-home IVIG to include CIDP and MMN, effective January 1, 2027 (in addition to primary immune deficiency diseases).
  • 2Keeps existing coverage for home IVIG for primary immune deficiency diseases, and extends it to more conditions treated at home.
  • 3introduces the possibility of different Medicare payments for home IVIG based on the condition being treated (PIDD vs CIDP/MMN), with the specific determinations to be set by the Secretary through rulemaking.
  • 4Requires rulemaking (notice and comment process) to define when and how payment variations apply by indication.
  • 5Represents a policy change intended to improve patient access to home-based IVIG therapy and align reimbursement with differing care needs and resource use across indications.

Impact Areas

Primary group/area affected: Medicare beneficiaries with CIDP or MMN who require IVIG and would receive it at home; patients with primary immune deficiency diseases who already may be receiving home IVIG.Secondary group/area affected: Healthcare providers and home infusion therapy providers who administer IVIG, as well as Medicare contractors and providers who bill under Part B for home infusion services.Additional impacts: Potential changes in Medicare spending for IVIG home infusions; implementation and compliance workload related to the rulemaking process to set differential payments; possible shifts in access or utilization depending on payment structures and the administrative requirements for home infusion.
Generated by gpt-5-nano on Nov 1, 2025