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119-hr-8528119th CongressWALLET

PI Post Acute Access Act

Sponsored By: Representative Smith, Adrian [R-NE-3]

Introduced

Summary

Expands Medicare coverage of intravenous immune globulin (IVIG) for people with primary immunodeficiency disease in skilled nursing facilities. The bill would add specific IVIG products and related items to the list of items and services eligible under the Medicare skilled nursing facility payment rules, using designated HCPCS codes and any later modifications by the Secretary, for items furnished on or after October 1, 2026.

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  • Patients and families: Would improve access to IVIG treatment for people with primary immunodeficiency disease who receive care in skilled nursing facilities by making those IVIG products and related services eligible under Medicare rules.
  • Skilled nursing facilities and clinicians: Would allow facilities to furnish and bill for the listed IVIG items using the named HCPCS codes (including J1561, J1569, J1576, J1568, J1459, J1554, J1557, and J1566) and related services when treating PID patients.
  • Medicare administration: Would expand the set of covered IVIG items and services under section 1888 of the Social Security Act and permits the Secretary to update the covered HCPCS codes.

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

More immune globulin coverage in Medicare SNFs

If enacted, the bill would add intravenous immune globulin used to treat primary immunodeficiency disease to the items Medicare covers in skilled nursing facilities. The bill lists HCPCS codes as of January 1, 2026: J1561, J1569, J1576, J1568, J1459, J1554, J1557, and J1566. The Secretary would be able to update that list later. The change would apply to items and services furnished on or after October 1, 2026. If you are a Medicare patient in a SNF who needs this treatment, this would likely lower your out-of-pocket drug costs or let the facility bill Medicare for these services.

Sponsors & CoSponsors

Sponsor

Smith, Adrian [R-NE-3]

NE • R

Cosponsors

  • Rep. Pocan, Mark [D-WI-2]

    WI • D

    Sponsored 9/28/2026

  • Rep. Van Drew, Jefferson [R-NJ-2]

    NJ • R

    Sponsored 10/5/2026

  • Rep. Matsui, Doris O. [D-CA-7]

    CA • D

    Sponsored 4/27/2026

  • Rep. Moore, Tim [R-NC-14]

    NC • R

    Sponsored 5/7/2026

  • Rep. Gottheimer, Josh [D-NJ-5]

    NJ • D

    Sponsored 6/2/2026

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 8/27/2026

  • Rep. Davis, Donald G. [D-NC-1]

    NC • D

    Sponsored 9/14/2026

Roll Call Votes

No roll call votes available for this bill.

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