H.R. 8528: PI Post Acute Access Act

This bill, known as the PI Post Acute Access Act, aims to improve access to skilled nursing facilities for patients with primary immunodeficiency diseases. The key points of the bill are as follows:

1. Amendment to the Social Security Act

The bill proposes an amendment to Section 1888(e)(2)(A) of the Social Security Act. Specifically, it adds provisions for coverage of certain medical treatments and related services for individuals diagnosed with primary immunodeficiency diseases.

2. Inclusion of Intravenous Immune Globulin

The amendment will specifically allow for the coverage of intravenous immune globulin that is indicated for treating primary immune deficiency disease. This includes specific coding for various types of immune globulin treatments that are to be identified under the Healthcare Common Procedure Coding System (HCPCS) as of January 1, 2026. The bill lists several HCPCS codes that will apply:

• J1561
• J1569
• J1576
• J1568
• J1459
• J1554
• J1557
• J1566

3. Related Items and Services

In addition to the intravenous immune globulin itself, the bill includes coverage for any items and services related to the delivery and administration of these treatments.

4. Effective Date

The provisions of the bill will take effect on October 1, 2026, meaning that the coverage enhancements will apply to services rendered on or after that date.

5. Purpose of the Bill

The main purpose of the PI Post Acute Access Act is to ensure that patients who suffer from primary immunodeficiency diseases have better access to necessary medical treatments in skilled nursing facilities. It focuses on improving their quality of care and treatment options within the healthcare system.

Relevant Companies

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