HR8528119th CongressWALLET

PI Post Acute Access Act

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

Introduced

Summary

Expand Medicare coverage for IVIG therapy for primary immunodeficiency disease (PIDD). This bill would let Medicare cover intravenous immune globulin and related services when IVIG is used to treat PIDD in skilled nursing facilities.

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  • Families and people with PIDD would see improved access to IVIG in skilled nursing facilities, so patients could receive clinically indicated therapy in that setting.
  • Skilled nursing facilities and clinicians would be able to furnish and bill Medicare for IVIG and the services needed to give it to PIDD patients starting on or after October 1, 2026.
  • The bill defines an initial set of HCPCS codes to identify covered IVIG products, including codes like J1561 and J1569 as of January 1, 2026, and gives the Secretary authority to update the list to reflect new products and services.

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Bill Overview

Analyzed Economic Effects

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

Medicare covers immune globulin in nursing homes

If enacted, this bill would let Medicare pay for intravenous immune globulin (IVIG) when given in a skilled nursing facility to treat primary immunodeficiency disease (PIDD). Coverage would apply to IVIG products billed with HCPCS codes J1561, J1569, J1576, J1568, J1459, J1554, J1557, and J1566 as of January 1, 2026. The Health Secretary would be allowed to update the list of covered codes later. The change would apply to items and services furnished on or after October 1, 2026.

Sponsors & CoSponsors

Sponsor

Smith, Adrian [R-NE-3]

NE • R

Cosponsors

  • Rep. Matsui, Doris O. [D-CA-7]

    CA • D

    Sponsored 4/27/2026

  • Moore (NC)

    NC • R

    Sponsored 5/7/2026

Roll Call Votes

No roll call votes available for this bill.

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